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6098
s 7f0,(1.E,vPCS Ec.5 Gq FP,Ey y ,€. *6 T.ec)sTE '9e2 Coots ri-ntirlost /o4 (Cook AVE. Mg777730& 33 GoR - /07 kv111JE,2 a?& —//G4) • • APPEALS BOARD MEMBERS .1• SOF Sot,,;- Mailing Address: Gerard P. Goehringer, Chairman �p`� OHO Southold Town Hall • 53095 Main Road • P.O. Box 1179 Ruth D. Oliva * * z Southold,NY 11971-0959 James Dinizio,Jr. � Office Location: ctt•Michael A. Simon O ,����t Town Annex/First Floor,North Fork Bank Leslie Kanes Weisman .fCOU ,�;�,'�� 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 EIVED4- FINDINGS, DELIBERATIONS AND DETERMINATIOINNI 2 0 1111 MEETING OF MARCH 13, 2008n: ZBA Application# 6098 Sou old Townn Clod Applicant/Owner: FRANCES J. COUTTS FAMILY TRUST Property Location: 10650 Sound Avenue at Corner of Factory Avenue, Mattituck CTM 142-1-3.3 This is an application for a Lot Waiver concerning a 16,599 square foot lot, merged as a single parcel as noted in the Building Inspector's September 6, 2007 Notice of Disapproval, under Section 280-11A to unmerge 10,007 square feet (CTM 142-1-3.2 vacant land) for the purpose of building a future dwelling, and 6,592 square feet (CTM 142-1-3.3 with a dwelling). The Zoning Board of Appeals held a public hearing on this application on December 20, 2007 and January 24, 2008, 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: Findings of Fact PROPERTY FACTS/DESCRIPTION: The applicant's property consists of a total land area (combined) of 16,599 square feet, identified as CTM 3.3 and 3.2 shown on County Tax Map Section 142, Block 1. The land is improved with a one-story, single-family dwelling, as shown on the August 29, 2007 surveys prepared by Stanley J. Isaksen, Jr. The property has 150 feet along Factory Avenue. BASIS OF APPLICATION: Article II, Section 280-10A, based on the Building Department's September 6, 2007 Notice of Disapproval stating that County Tax Map Parcel Numbers 3.2 and 3.3 are merged pursuant to Section 280-10A which states: "Merger. A nonconforming lot shall merge with an adjacent conforming or nonconforming lot which has been held in common ownership with the first lot at any time after July 1, 1983. An adjacent lot is one which abuts with the parcel for a common course of fifty (50) feet or more in distance. Nonconforming lots shall merge until the total lot size conforms to the current bulk schedule requirements." Page 2—March 13, 2008 • • ZBA#6098—Frances J. Coutts Family Trust CTM 142-1-3.3 ADDITIONAL INFORMATION: Charles R. Coutts Jr. and Frances J. Coutts, his wife, purchased their single-family dwelling at 1570 Factory Avenue (lot 3.3) in 1940. In 1973 Charles R. Coutts Jr. purchased the adjoining parcel of land know as 10650 Sound Avenue (lot 3.2). The property has not been improved. In 1996 Charles R. Coutts Jr. died leaving Frances J. Coutts as his sole heir at law. Upon his demise the properties merged by operation of law. In July 2006 both properties were transferred to the Frances J. Coutts Family Trust for estate planning purposes. After Mrs. Coutts' funds were exhausted, the Trust applied for Medicaid. The application was denied, based on the assumption that the properties had not been merged. In March of 2007, Chapter 280-10 of the Southold Town Code was amended to create an exception to the merger law for lots that "would be considered merged merely by operation of law as a result of the death of a co-owner of one or more of the adjoining lots, the lots are greater than 20,000 square feet, and the lots remain in the ownership of the surviving co-owner." (Chapter 280-10C-6). This new Exception to the Merger law would have exempted these two lots, which had been single and separate, had they not been transferred to a family trust the year before the law was passed. The result would have made the current application for a waiver of merger unnecessary. A medical diagnosis dated February 14, 2008 indicates that Frances Coutts does not need to remain in nursing home care if sufficient medical and personal support can be provided for her at her home. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: 1. The waiver will not result in a significant increase in the density of the neighborhood. Lot 3.3 is already improved with a small dwelling and only one additional dwelling could be built on the remaining CTM lot 3.2 in this grant of a waiver, which does not create significant additional population density in this neighborhood. Moreover, because CTM lot 3.2 is a corner lot with two front yards, the code-required setbacks and permitted lot coverage suggest that any future dwelling on this +/- 10,000 square foot parcel would be modest in size, in keeping with the neighborhood, and likely suitable for a relatively small household. 2. The waiver would recognize a lot that is consistent with the size of lots in the neighborhood. County Tax Map Section No. 142 District 1000 shows described lots located between Factory Avenue to the west, Walnut Avenue to the east, Sound Avenue to the North and the LIRR railroad tracks to the south. The Coutts parcel that is improved with a dwelling (lot 3.3) is +/- 7,000 square feet and is narrow and deep (50' x 142') and typical of many of the lots in the neighborhood (for example lots 2, 4, 8A,14, 15, 17). There are only two or three lots that are larger than the Coutts' Lot 3.2 (for example 16.2, 7A) and one or two of approximately the same size. Therefore unmerging the two lots as requested by the applicant will legally re-create Page 3—March 13, 2008 • • ZBA#6098—Frances J. Coutts Family Trust CTM 142-1-3.3 two properties that visually already appear as two separate lots, both of which are in keeping with other lots sizes in the neighborhood. 3. The waiver will avoid economic hardship. In 2006 Frances J. Coutts entered a nursing home and a family trust was established naming Geoffrey R, Hallenbeck III (her nephew) as Trustee to ensure that funds were available to pay for her care. To date these private funds are virtually exhausted. • As of 1-14-08 information was submitted to show a $1,626.05 balance in the Frances J. Coutts Family Trust under North Fork Bank Checking Account. • As of 1-1-08 The Family Trust owed the nursing home $60,677.74, confirmed in a bill/statement issued 1-01-08 by San Simeon by the Sound. • As of 1-30-08 The Family Trust owed $8,159.65 for medications she received at the nursing home, confirmed in a statement issued by Shore Pharmaceutical Providers Account 40124. To provide for Mrs. Coutts medical care, after his funds were exhausted, her agent applied to Medicaid on her behalf, but the application was denied with Determination #U471M56530 issued November 16, 2006 under Case #M00A55837 that Mrs. Coutts' countable resources were too great, based upon the assumption that the lot with her primary residence, which qualified for an exemption from the valuation of her assets, and her unimproved lot had not been merged. The owner's primary residence would have been found exempt from the valuation of her assets, had the Medicaid board known that the lots had been merged at the time of the application. In addition the March 2007 amendment to Chapter 280-10 of the Southold Town Code (see Additional Information, above) would have exempted these two lots from the Merger law, had they not been transferred to a family trust the year before the law was passed. The result would have made the current application for a waiver of merger unnecessary. Based upon these facts, and the fact that a forced sale of the property would preclude the possibility of Mrs. Coutts returning to her home, the Board of Appeals believes that a denial of the application to unmerge the lots would result in severe economic hardship. The Board notes that the 2007 Code amendment to the Lot Creation and Merger Provisions was created precisely to prevent the type of hardship caused by mergers upon death that Frances Coutts could have experienced. 4. The natural details and character of the contours and slopes of the lot will not be significantly changed or altered in any manner, and there will not be a substantial filling of land affecting nearby environmental or flood areas. The subject property (lot 3.2) is essentially flat, covered with grass and ground covers, and has slightly elevated berms along the Factory Avenue and Sound Avenue road frontages. There are several large holly and evergreen trees on the property. No significant re- grading would be needed to construct a dwelling on this property, and there are no environmentally sensitive areas nearby. Page 4—March 13, 2008 • • ZBA#6098—Frances J. Coutts Family Trust CTM 142-1-3.3 RESOLUTION OF THE BOARD: In considering all of the above factors and applying the standards of the Town Code, Sections 280-11, motion was offered by Member Weisman, seconded by Chairman Goehringer, to Grant the Waiver to unmerge lots, as applied for. Vote of the Board: Ayes: Members Goehringer (Chairman), Oliva, Simon and Weisman. (Member Dinizio was ab Reso was duly adopted (4-0). /GE D P. GOEHRINGER, CHAIR k 3/18/08 pproved for Filing FORM NO. 3 TOWN OF SOUTHOI, ) • BUILDING DEPARTMENT OCTa ` '"' SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date: March 8, 2007 Renewed: September 6, 2007 TO: Geoffrey Hallenbeck Trustee of F Coutts Family Trust 2700 Camp Mineola Rd. Mattituck,NY 11952 Please take notice that your application dated February 23, 2007 For a permit for merger determination at Location of property 10650 Sound Ave., Mattituck,NY County Tax Map No. 1000—Section 142 Block 1 Lot 3_2 Is returned herewith and disapproved on the following grounds: The subject lot has merged with an adjacent lot SCTM#1000-142-1-3.3 pursuant to Article II, Section 280-10(A) which states: "Merger. A nonconforming lot shall merge with an adjacent conforming or nonconforming lot which has been held in common ownership with the first lot at any time after July 1, 1983. An adjacent lot is one which abuts with parcel for a common course of fifty(50) feet or more in distance. Nonconforming lots shall merge until the total lot size conforms to the current bulk schedule requirements." Authorized Signature 777r. Co cals r OCD SOUND AVENUE N/F GEOFFREY ('�`� FRANCIS J.R HALLENBECK 111 os trustee J '` / N o COUTTS FAMILY TRUST OF THE / _ 77°06 10"E °i- DATED Ju�Iy 27, 2006 �KJ D 'd' Z Z o m CHAIN LINK—FE — O N/F MARCHICA mAm 142.37' o Ja 34.Z• 39.7' N/F LEE v STOCKADE ---FENCE -7 1.1• _a CONC CELLARi� STOOP N ENTR WOOD FRAME RESIDENCE oti a N cn ;41 • / c4C1- OC m--*-0.3.a 32.8' ■ 29.7. CONCRETE z no y o {� oo 14.2' m N ._.a N/F DOHM co Ul 00 v z ::-JitCARPORT L.71 GARAGE rn m Cb m - N O m N O O 16.0' a 0.2' - ' CHAIN 22.1 LINK 24.2' m ON LINES 74° 1 4'30"W FENCED' 0 142.00' N/F RACANELL w LteiSURVEY OF DESCRIBED PROPERTY SURVEYED: 29 AUGUST 2007 GUARANTEED TO: SITUATE GEOFFREY R. HALLENBECK III MATTITUCK, TOWN OF SOUTHOLD SCALE 1 = 20' 4 SUFFOLK COUNTY, N.Y. AREA = 6.592 S.F. OR 0.151 ACRES GUARANTEES INDICATED HERE ON SHALL RUN SURVEYED FOR: GEOFFREY R. HALLENBECK III ONLY TO PIE PERSON FOR WHOM THE SURVEY as trustee of the IS PREPARED. AND ON HIS BEHALF TON Y. FRANCES J. COUNTTS FAMILY TRUST LE COMPANY, GOVERNMENTAL ONHI AGENCY, SURVEYED BY TOLENDING TNE ASSIGNEES INSTITUTION, LENDID NG INSTITUTION. dated July 27, 2006 STANLEY J. ISAKSEN, JR. ', GUARANTEES ARE NOT TRANSFERABLE TO P.O. BOX 294 ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. NEW SUR'OLK. N.Y. 1 1 9 I UNAUTHORIZED ALTERATION OR ADDITION TO THIS TM// 1000-142-01-003.3 631-73 5835 // SURVEY IS A NOVATION OF A TION 7209 OF ���' f� THE NEW YORK STATE EDUCATION LAW COPIES OF THIS SURVEY MAP NOT BEARING THE ELAND SURVEYORSEMBOSSEDBEVA SEAL SHALL LI NSED S �' [YO!\ NOT BE CONSIDERED i0 BE A VALID TRUE YS Lic. o. 492 3 07R 1607 r • ' • SOUND AVENUE N 77°06 ' 10 "E 100.37' Z -� 1 .0' CO C a rri CO 0 fv O VACANT LAND -11(73 I S E� _ O FENCE CD 4 m o / m - CHAIN LINK FENCE 1 . SOUTH OF PROP LINE S 77°0610 'W N/F GEOFFREY100.37' FRANCIS J.R. HALLENBECK 111 as trustee COU NTTS FAMILY TRUST, °f t dhe oted JULY 27, 2006 SURVEY OF DESCRIBED PROPERTY SITUATE MATTITUCK, TOWN OF SOUTHOLD OCT 1 5 SUFFOLK COUNTY, N.Y. Coot SURVEYED FOR: GEOFFREY R. HALLENBECK III as trustee of the FRANCES J. COUNTTS FAMILY TRUST SURVEYED: 29 AUGUST 2007 TM# 1000-142-01-003.2 SCALE 1'= 20' AREA = 70,007 S.F. GUARANTEED TO: OR GEOFFREY R. HALLENBECK III 0.229 ACRES GUARANTEES INDICATED HERE ON SHALL RUN SURVEYED BY ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO iNE STANLEY J. ISAKSEN, JR. 77TLE COMPANY, AGENC LENDING INSTITUTION, IFNISTEDLHEREON,AND P.O. BOX 294 TO THE ASSIGNEES OF THE LENDING INSnTUnom NEW SUF OLK. N.Y. 11956 GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS 631 -73 jil-5835 UNAUTHORIZED ALTERATION OR ADDITION TO THIS ,-'�� , SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF TMS SURVEY MAP NOT BEARING LI - NSED •ND SU'I'EYOR THE LAND SIRVEYORS EMBOSSED SEAL SHALL I' S LIC. O. 4927 . . 07R1607—1 NOT BE CONS ED TO BE A VALID TRUE COPY • • • • WAIVER TO UNMERGE PROPERTY APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS � [ ForOffice/Use/Only OCT 1 5 2007 Fee:$ 16 1) Filed by:F/4 pp Date Assigned/Assignment No. � Office Notes: V 70-- Parcel Location: House No. 10(0P Street ScWil ,4i/crx c Hamlet M Otflit GIC SCTM 1000 Section I`f2.COBlock DI.UOLot on3•°` of oo 3•COtot Sizes : o�0O7 S1 Zone District R 40 04- &592 sf APPLICATION BASED ON THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED: 3/ HHo 7- VCntLJrc( ( 03- Geoffrey K. Hot lien loccxn aJ llusitro& Applicant/Owner(s): the Freviccs T. CLO* Farm trust data 1127/ao Mailing Address: alio camp Him r-o I c.. rp� �� 1(j N „{� Telephone No: ( (p 3 I o['1 F -Si 4/ Fax No. VI Note: If applicant is not the owner,state if applicant is owner's attorney,agent,architect,builder,contract vendee,etc. Authorized Representative: baV cd w, Oat/ (Ciao, Siegel i S1rott, Address: 11001 .11cfCra!'IS tfiqiiont4 , Sl39)t -s IOUI a i a. (1"1 119 Telephone No: ((P31) a3t(- 3630 Fax No. (o31 - a3'j - 31*1 J Please specify who you wish correspondence to be mailed to, from the above listed name : � ietApplicant/Owner CtVl . --orized Representative ❑Other: WHEREBY THE BUILDING INSPECTOR DENIED AN APPLICATION DATED a/a3lo?FOR: ❑ Building Permit ❑ Change of Use ❑ Certificate of Occupancy ❑ Pre-Certificate of Occupancy ❑ ,Permit for As-Built Construction Other: WWI rr bt- MCr5er Provision of the Zoning Ordinance Article II Section 100-26 A prior application 0 has as not been made with respect to this property under Appeal No. Year . (Please briefly explain) • • • • • Name of Owner Parcel Lot No. C C j 1 5 L,.. This review is for lots, which have separate deeds recorded prior to 1983 and undersized. A merger determination has been issued by the TowniBuilding Inspector(copy attached). The zoning of these properties is presently: R "1 The size requirement for this zone is: ,.(2 Cit square feet per parcel. The lot to be unmerged is /0,00? square feet. The lot remaining is 459 square feet. -FLAW!. wf Lire EV" e Co,th I (we), CC f{r t2•HAllenbccK.E , FAn s o s econtigu usots shown on the attached deeds, request a determination by the Board of Appeals to determine whether or not these parcels quality for a"waiver" under the merger provisions of Article II, Section 100-26 of the Southold Town Zoning Code, and if qualified, to grant a waiver to unmerge Lot No. 003 . 00 2- . I hereby submit all of the following documents for reliance by the Town of Southold in making this review determination: ,1!Copies of my recent tax bill for both(all) lots. ,2<Copies of deeds dated prior to June 30, 1983 for all lots. Copies of current deeds of the parcels under review. /1!Copy of the current County Tax Map for my neighborhood. A' $150.00 application check which is not refundable if this waiver is denied. efir'Other documentation as may be requested by the Board of Appeals. I understand that if an unfavorable waiver action is issued by the Town of Southold, that I reserve the right to file for a subdivision and, if necessary, area variances under Appellate procedure. By making this application, I hold the Town of Southold free and harmless from any and all claims and liability resulting from the issuance of a waiver. Pleaseeacheck one or more of the following: The lot was not created by approval of the Town of Southold, and was created by deeds dated M ayy3, 1 Q 4 0 for Lot# 3.3 , and deed dated ()ember er 30,IQ{3for Lot# 3 .2 ❑ The lot(s) in question has been approved by the Southold Town Planning Board dated (attach copy). ❑ The lot(s) in question has approval and is shown on a subdivision map approved by the Southold Town Board prior to June 30, 1983. • ',of* .0 • VP '6 /Ass/1-Q\ ' SUMMARY Francis J. Coutts Family Trust by G. Hallenbeck III, Trustee Case Number: #6098 Factual Summary On May 3, 1940, Charles R. Coutts Jr. and Francis J. Coutts, his wife, purchased a single family home at 1570 Factory Avenue, Mattituck, New York. The premises at 1570 Factory Avenue, Mattituck, New York is identified as Section 142.00, Block 01.00 and Lot 003.003. On October 30, 1973, Charles R. Coutts Jr. purchased the adjoining a vacant parcel of land known as 10650 Sound Avenue,Mattituck,New York. The property at 10650 Sound Avenue,Mattituck, New York is identified as Section 142.00,Block 01.00 and Lot 003.002. The property has not been improved. Charles R. Coutts Jr. died on May 8, 1996. Francis J. Coutts was the sole heir at law of Charles R. Coutts Jr. As a result of Charles R. Coutts Jr.'s demise,the properties merged by operation of law. In July 2006, both properties were transferred to the Francis J. Coutts Family Trust for estate planning purposes. Francis Coutts has been privately paying for her nursing home care. Francis Coutts no longer has the liquid assets to pay for her nursing home care. In fact, she owes a substantial amount of funds to San Simeon as evidenced by the attached nursing home bill. Francis Coutts also owes Shore Pharmaceuticals a substantial amount of funds for medications she has been receiving in the nursing home as evidenced by the attached bill. Francis Coutts has no way to pay the aforementioned bills.At this point in time,the value of Francis Coutts' bank accounts total less than$3,000 dollars as evidenced by the attached bank statements. In February 2007, Francis Coutts' agent considered having her discharged from the nursing home to her home with twenty four hour care. However,just prior to having her discharged, the agent decided not to have her discharged concerned that she would quickly run out of liquid funds to privately pay for her care at home. The only asset that remained available to Francis Coutts to pay her outstanding medical expenses and that would enable her to maintain her home and be discharged to home would be the sale of the vacant lot located at 10650 Sound Avenue, Mattituck, New York. As a result, Francis Coutts' agent filed an application for a permit for merger determination on February 23, 2007, which was denied on March 8, 2007. 1 I In the summer of 2007,Francis Coutts' agent rented the single family house located at 1570 Factory Avenue, Mattituck, New York in an effort to continue to pay the expenses related to the property. At this point, Francis Coutts' agent has retained an attorney to evict the tenant located on the premises. The only asset available to Francis Coutts to pay her outstanding medical bills and the expenses related to her home is the vacant lot located at 10650 Sound Avenue,Mattituck,New York. Francis Coutts will realize severe economic hardship is the application to unmerge the lots is denied as she will not be able to pay the expenses to maintain her home and she will not be able to pay for her past due medical bills and anticipated future medical bills. 2 a lu-n 11.,.. ... 1r:oiinlT uviililcT'"'- DEPARTOF HEALTH I il N51S5E9NNMDED CERlCATE 0 411 • OF DEATH I OC i 5 _I 1.NAME:FIRST MIDDLE LAST- 2.SEX: 1 RA.DATE OP DEARI' H5,1101111. MALEFE�.Z - I.IDNIH UA�Y7 Y /'i CHARLES • R. COUTTS SI a �Q j=`"' /} m 3SIOENCE °A'(CI'rrkmy non/" HOSPITAL D HO1l(''PAITAL L HMI INPA'ITAL 11ENI "DOME RESIDE NIT DITIER(F/vnlryl ;'H VA 11€AUMI FACILIT TIMU: _MQNIII DAY YEA..!) `, ``�� I 0 i ❑ 2 ❑ 3 u A _.u 1 I NCHS 4C.NAME or FACILIIP pl no(facility give mattress) 411 LOCALITY:(Check one and epenly) ---- 4F..COIIIJIV OF DEA TIT 1570 Factory Ave. ; `I'°°f VILLAGE or "'W""F I ❑ XX ❑ Mattifurk I Suffolk_ 4E.MEDICAL RECORD NO X40.WAS DECEDENT IDANSIERI TED FROM ANOII IER INS II I LITIOH:Idtme.!Terrify institution Tune,cur or town.ronni'mud Milo) NO YES 4C I 1& ❑ 5.DATE OF BIN III: D,AGF"1 IF IINI)Fn 1 YEAR IF IINIIEn I DA77 TA_CIIY AND STATE or milt:(fnuna�2R 10-414/TrR 1 VFAn,NAME Or if mg El SA) ' ❑ RIn 111' MONTH DAY YEAR 1,__In• d54 : nwi. 51,,, _: 4G Sep 14j1909 86 yrs.! � � ; Mattituck, NY B.SSERVED IN U.S.ARMED FORCES, S.RALE (Mirk.While, I 1 In.I IICrANIC OnImN2 PI - DECEDENT'S ...I- NO YESl 0'^III I I UEGEDENI 5 EDUCATION(Specify M1ll highest (I(lP completed) TAINW pp''TT 11�� (Specify lows) NOp1 YES _ _ UJa LJ 1 white IN ❑ FI v/Com nIme In 121 6 CollorII 11 WI 12 SOCIAL Srl111115 N11MR1II: 19.MANUAL -- --- -- "�"_ -' -------- NIIRH' MEPAII:I FR M BlI11VIVIM(. SPOUSE:111 /.r vnM n:: nml S1All1$ NAlIN1E11 CFPAIIAIED WIDOWED IIIV]IIrFR 094-01-9773 y Frances Waltgp ]R ------- D 1 32 _ ❑3 ❑4 15A,TIM TAI MCI IPA NON:(Po not 1`11/4.1 Wh1 Jl ;1741.IITTI OI DIORITES:011 INPIISIIIY �I1. NAME AND ITV OI COMPANY nI11111M welder Welding Company Eastern Welding Co Riverhead,NY --- S IRA.RFSIDFNC.F,HTAIF: -TAR COIILIIV'- -- ---, IBC L1)('AI IIP'Check nor and yx'I/y)_. - - -- --- - IIB0.IF CITY(111 VILLAC•G.IS DTI%.OI VILLAGE Or 11 MN Or RESILIENCEWIIIIN DIIY OR N. Y. 1 Suffolk VLUGE LIMItS:Uvesl]Lm 1`r11 Mattituck IIF ).BrrarYlOwN _ _ Ifin.SIRFFF AND NUMBED OF nF.SIDFNCF' ----"— ----- Ir,E PIP rv1nF II • I Factory Ave ; 11952 ; Southold 12.NAME OFFInSI MI LAST IS.MAIDENNAME .-FIRST - MI I AST -- PATI'Ent OF MO111P0: SCharles E. Coutts Effie Worthington ISA.NAME Or INFORMANT: 1 TAA.MAKING AnnfES5:imowP no rode) -- Frances Coutts X1570 Factory Ave Mattituck, NY 11952 25 2on 0A.O 1URBURIAL,CREMTITION,REMOVAL MON1H_ DAY YEAR 200 PLPLACER FeunDISPOSIOCCREMATION.REMOVAL OR X200.LOCA IION'hily'm town and slob) --" Bial 961 Sacred Heart Cemete I urMa Cutchosue, NY o I yTi� 30 p 21A,NAME AND ADDRESS OF FUNEMI.HOME: 1 210 IIEGIBIOAIIOFI NUMRFR. g DeFriest Funeral Homes, Inc Main Rd Mattituck_, NY _ 1 00.500 y -o 22A.NAME OF FUNERAL DIRECTOR: Imo1 220.SIONAI E OF FUNERAL UInEC IOn: 1 220,.REnTsi DATION NUMBER: 31 David E. DeFriest �f 3 -sue- '►_ CCS-l1' E. ��n •lit-c.oy� i 01203 -----Iy-- 23A.SIGNALURF OF Of:01ST-MW_ 1 FIl TIME 24A.HOIIIAL OR nf.IAOVAI.PERMIT-ISSIIFD RV. I ISSUED ED FILLFD' MONIII DAY _YEAR_ 310 DATE I IISSNFP: MUP1111 DAY YEAH _L 5_--- 1166 (� -J _ ca,t�.�Qn( �t914QUc-�----L5 1 OL96 ITEMS 2 -33 COMPLETED BY CERTIFYING PHYSICIAN -OR- ITEMS 25-33 COMPLETED BY CORONER OR MEDICAL EXAMINER On 25A.TO II IF REST OF MY KNOWLEDGE,DEAI IT OCCIIRIIEn Al IIIF IIMF,I 25A ON IIIE BASIS Or IIJVFSI IGAI1011 AND SIICI F.KAMINAIIONS. I cpnnOFR AIIU PLACE ARID DUE 10 I HE CAUSES STA I FII. ASI?EI.I NECESSARY.IN MY OPINION UFA I N(X:CUDNED A 11I IFI SIGMA.URF. 11MF,MIF AND PLACE AND OIIF.1(1 IIIE.CAUSES STAIR). CINI(tNrn' - // J� MONTH DAY YEAR I 1 IIIYSICIAN Int( •4 + " is ) I a' [ MEDICAL OS ► ..[�'1`C I fir ' K 31 EL:. I ST I lJ�/� ANDJ111LIEF ► LJ EXAMINED LHS. 258.111E PI IYSICIAN ATTENI - 111E DECEASE!) 250USI SEEN ALIVE: 258.PnoNo1NCED DEAD 1 250.1101111:-�P511 DATE SIGNED W I I E MONTH DAY YEAH MONTH DAY YEAR MONTH DAY YEAR MONTH DAY YEAH I I AW_NIlI DAY YEAR_ )GGD rROM I TO CC �L/Ip ,p} Alit_ -� M I- j 254 NAME OF IT EN IING FIT NG'YSICIAN,�l� " T't- ON I I - 25E.SIGNATURE OF CORONEII On CpRONEws nlYSICIAIJ,IF 0111ER TITAN CEn11rim- 1NCER 25D.ATTENDING PHYSICI�CENSE NUMBER u�/• • .'r 2w MEA'.OR 1111.9. -- _-" !!!!!! / �� LICENSE NUMBER 213.NAME AND ADO1+ESS•F CE T1IEO HO SIGNED 25A _ -- ---- ----- 4ICbb iU `)"c«T I 1.31 v ',-9'c �,•C/ l 11' 1(7 r-- y //i�Y 27.MANN R OF OEAITI UNDETERMINED PENDING 2A.WAS CAS EteRRED 10 A.AUTOPSY: 1298 IF YES,WFIIE FIHOINns USED IJATUNAI. USE ACCIDENT I• ICIRE SUICIDE CIRCIIMSIAIICES INVES�I DOA DON CO"ONET1 OR MEDICAL FXAMINFR? 110 YES I1(I nFIFI11A1nF CAUSE Or DfATII' 1 ❑2 ❑a ❑4 ❑3 fJ 8 �/ a NO ❑ I YES 0 ODONUQYES_ STATE OF NEW YORK COUNTY OF SUFFOLK Office of the Registrar of ss: Vital Statistics of the I, JUDITH T. TERRY, Registrar of Vital Statistics of TOWN OF SOUTHOLD the Town of Southold, DO HEREBY CERTIFY that I have compared the attached copy, with the endorsement thereon, of the Death Certificate of (Seal) trk-IARI,E$ R. COUTTS with the original now remaining on file in this office, and that the same are correct transcripts therefrom, and of the whole of said original. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal, this,1,0.th• .day of . My!! 1l 1w-.. 9... • (44.40:4.4(-4....„.."1: .,.r'P. Y4 .v1`, -- ,. - ,' -.- 4. Registrar of Vital Statistics Town of Southold • • • • Name of Owner Parcel Lot No. ❑ The lot(s)in question is/are approved and/or recognized by formal action of the Board of Appeals prior to June 30, 1983. ❑A certificate of occupancy was issued for the house on lot REASONS: (1)The waiver will not result in a significant increase in the density of the neighborhood because: on lots ,n /tic net hborhooa an of similar size In lab B.2 and T.3 . (2) The waiver would recognize a lot that is consistent with the size of lots in that neighborhood because: See Count/ Talc lap bSr the. neiqhborhumt (3) The waiver will avoid economic hardshi because: Fr(b)W w CovNs reging leolo toau horsn Ilan] nbone , bill while S1rl( being ►e lO lit r#rcw '�cGcul in . cvrnf she -K. a.bw - re om hrrh_t__ (4)The natural details and character of the contours and slopes of the lot will not be significantly changed or altered in any manner, and there will not be a substantial filling of land affecting nearby environmental or flood areas because: (Attach additional sheets if needed). �/// 1 1./d/hate, ZIA / / gr lir i i i ner Sworn to before me this pazpQ day of I40A4 , 2 003 JJ ci, 1 < 14te�nt Matt Notary Publi MICHELLE BLACK JABLONSKY Notary Public State of New York No. 0261 .8011988 Qualified In Suffolk County Commission Expires August 17,20 1 ZBA 12/95; 3/06 ' r LOT WAIVER QUESTIONNAIRE 1 What are the square footage and dimensions of this lot (subject of building department merger application): /4007. s.f. la ft. by /Obi3 - ft. Date of first deed which created this lot: 0 C o 1Cr 30i 073 eoIfrts K. Haurnmcc Ill Cgs of current deed to present owner' Titiflu of -the Franrcr 7. CcviP Family Ta/S1' / Owners' names of lot at current time: July ca 7. G004, Date and name of subdivision (if any): n/& Size of remaining lot in the merger: �$9a s.f. Were there any building permits issued in the past for this lot: Yes No If yes, please provide copy of former permit and map approved. W ,ere there any County Health Department approvals in the past for either lot? Yes No V If yes, please provide a copy. Were they any vacant land Certificates of Occupancy requested in the past? Yes No ✓. If yes, please provide a copy. Were there any other Town actions (approvals or denials) in the past regarding this property (such as a pre-existing Certificate of Occupancy for a preexisting building, a variance, lot-line change, Trustees approv 1, or other type of application to build or use the property in any way)? Yes _ No J If yes, please provide copy (if available), or explain: Is there any building or structure, such as a patio, driveway, or other, overlapping the • deeded Ipt line which separates the two merged lots? No. ✓ Yes If yes, please explain. How many other vacant lots are on the same block and immediate neighborhood? Please note other approvals or other information about common ownership of these lots: nf& '10 mu Knu 8, I am an owner of the subject lot and the above information is provided to the best of my knowledge. (Copies noted above are attached.) Dated: ilaw - i Ayr, / '�. , Ap C;P-----'"- -.... 'Owl- '' Si.nature ZBA5/27/99 QUESTIONNAIRE FOR FILING WITH YOUR Z.B.A.APPLICATION C ° A. Is the subject premises listed on the real estate market for sale? ❑Yes 'lo B. Are there any proposals to change or alter land contours? ❑Yes glo C. 1)Are there any areas that contain wetland grasses? N 6 2)Are the wetland areas shown on the map submitted with this application? tJ /a 3)Is the property nu/k 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 Town Trustees for its determination of jurisdiction? si/4 Please confirm status of your inquiry or application with the Trustees: D. Is there a depression or sloping elevation near the area of proposed construction at or below five feet above mean sea level? js1/4 (Please show on photos.) (If not applicable, please add N/A,) E. Are there any patios,concrete bathers,bulkheads or fences that exist and are not shown on the survey map that you are submitting? N"A n oat (Please show area of these structures on a diagram if any exist. Or state"none"on the above line, if applicable.) F. Do you have any construction taking place at this time concerning your premises? NO Q If yes,please submit a copy of your building permit and map as approved by the Building Department and describe: . G. Do you or any co-owner also own other land close to this parcel? N Q If yes, please label the proximity of your lands on your map with this application. • H. Please list present use or operations conducted at this parcel P.xistrn9 :s i!1 Ql Cfain1tv and proposed use to be added n2Sf l/✓Q(`Lill f !� (examples: existing: single-family;proposed: same with garage.) I. Please disclose the names of the owner(s) and any other individuals(and entitles having a financial interest in the subject premises and a description of their interests: (Separate sheet may be attached) ael2M&KM211.1.412CCIT ad ivuStr of th•c 1tnC-Co a Ca)tb ThinibTite data 7/274Cb Jst. :: 'i• - 7 d Date ifr ZBA 2/05;3/06 TOWN OF SOUTHOLD • , BUILDIl'ERPAPPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey www. northfork.netlSouthold/ PERMIT NO. Check Septic Form N.Y.S.D.E.C. ._ Trustees Examined ,20 Contact: Approved ,20 Mail to: Disapproved a/c Pc 3Ag'/7 , Phone: c27p /� 7 y/y Expiration ,20 I rfl -) Building Inspector FEB 2 8 2or'' APPLICATION FOR BUILDING PERMIT { Date Q /a1 /D7 , 20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector 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 occupied 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 commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building 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 construction of buildings, additions, or alterations or for removal or demolition as herein described.The applicantthrizes to comply on with all applicable laws,g ordnecesces,sary bunspecti code,housing code, an re�trlatia y o a IC�,�a authorized inspectors on premises and in building for necessary inspections. a<�'�P�d CC�dK���]����/ J ;//(eO�7•. R � lig 1;01.(Signature of applicant or name,if oration) 2700 C amo /Trite/& 4oad M ft 4f { v 1.4 f) y. i052- (Mailing address of applicant) State whether applicant is owner,Llessee, agent, architect, engineer, general( contractor, electrician, �pllumbeerr'or builder-r C3eo1 fTel R R . LIQ i/ beck - 17:1-trier d l r lecln�cn j. 1..oa+ s fe;rh INNS Name of owner of premises {/ (As on the tax roll or latest 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. • 1. Location of land on w ch propo ed ork will be done: 10106.0 oun] Fve Ma++..tmciA House Number Street Hamlet County Tax Map No. 1000 Section / H Block I Lot 3 .2 ., Subdivision Filed Map No. Lot (Name) 2. State existing use and occu 2y of liaises and intended use and panceproposed construction:- a. Existing use and occupancy b b. Intended use and occupancy To be So Id 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front tar, ,' Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front It OD ' Rear D0 Depth /DO� 1 10. Date of Purchase 16'301 b Name of Former Owner CFIa an C.ou LIS Sr. 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES 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 NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTYO F ) C—% ire Q 4'1 lee 6P�'4W being duly sworn, deposes and says that(s)he is the applicant (Name of gividttal signing contract)above named, (S)He is the (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 manner set forth in the application filed therewith. Sworn to before me this d7.and day of 20 0 7 / Not Public Si// !ature of Applicant LINDA J COOPER NOTARY PUBLIC,State of New York NO.01C04622563,Suffolk Counyt�� Term Expire;December 31,Z0,((1 S Office Location: ,,''�,,,, OFFO/ USPS Mailing Address: OG' Town Annex/First Floor,North Fork Bank J o yd S 53095 Main Road 54375 Main Road(at Youngs Avenue) w Z : P.O. Box 1179 Southold, NY 11971 O .F Q� Southold, NY 11971-0959 http://southoldtown.northfork.net BOARD OF APPEALS �n TOWN OF SOUTHOLD Tel. (631) 765-1809 Fax(631)765-9064 / II March 19, 2008 By Regular Mail and Fax Transmission 234-3140 Michelle Jablonsky, Esq. Davidow, Davidow, Siegel, Stern 1601 Veterans Hwy., Suite 330 Islandia, NY 11749 Re: ZBA File No. 6098 — Lot Waiver (Application by Frances J. Coutts Family Trust) Attn: Sylvia Dear Mrs. Jablonsky: Please find enclosed a copy of the ZBA's March 13, 2008 Determination under Zoning Code Section 280-11, the original of which is also filed with the Town Clerk regarding the above lot waiver application. Thank you. Very truly yours, Linda Kowalski Encl. Copies of Determination also to: Town Clerk (original) Building Department (copy) 'ii iiiii�- '' S OUTy • - ELIZABETH A.NEVILLE 1�i 4 Town Hall, 53095 Main Road TOWN CLERK d •y: P.O. Box 1179 REGISTRAR OF VITAL STATISTICS 4 T Southold,New York 11971 cr. be ` Fax (631) 765-6145 MARRIAGE OFFICER G Q �` RECORDS MANAGEMENT OFFICER icR �0 11 Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER �� southoldtown.northfork.net cowl i - ... 0_i OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Zoning Board of Appeals FROM: Elizabeth A. Neville DATED: October 18, 2007 RE: Zoning Appeal No. 6098 Transmitted herewith is Zoning Appeals No. 6098 of Geoffrey R. Hallenbeck III as Trustee of the Frances J. Coutts Family Trust- the Waiver to Unmerge Property Application to the Southold Town Board of Appeals. Also enclosed is the Applicant Transactional Disclosure Form, Lot Waiver Questionnaire, Cover Letter from Michelle Jablonsky of Davidow, Davidow, Siegel & Stern, LLP, Questionnaire for Filing with the Z.B.A. Application, Title Search, (2) copies of the Deed for TM# 142.-1-3.003, (2) copies of the Deed for Tm# 142.-1-3.002, Town of Southold Property Record Cards for both parcels, Copy of current tax map for the neighborhood, Notice of Disapproval, Application for Building Permit, Surveys for both parcels, copies of recent tax bills for both lots and a copy of Death Certificate for Charles R. Coutts. ` Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 10/17/07 Receipt#: 29 Transaction(s): Reference Subtotal 1 1 Application Fees 6098 $150.00 Check#: 107 Total Paid: $150.00 Name: Hallenbeck Iii, Geoffrey R. Trustee For Frances J Coutts Family Trust 2700 Camp Mineola Road Clerk ID: MICHELLE Internal ID:6098 TOWN OF SOUTHOLD PROPERTY RECORD CARD Joao - 17/a -/- OWNER STREET /6 • A VILLAGEILDIST. SUB. LOT rances 3. f! x j#s Cana Ult*. pa Jn(` -A-ve--,4 ��✓ 7J es e., FORMER OWNER l N E R. C. - A. . •., o _ ._ o 4 00 S W TYPE OF BUILDING / .al NS L. u" a e--61-10 MAs• aM SEAS. VL. FARM COMM. CB. (MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 0-0 e-e) //a..0 A- 40 - I_i .. 09.; . a 90 IIMMI f 34 5' IMIt . _ e P, _ - . ® LYl„„4 2 `- �� �'`6 �� / /4 P3 " .J7 .WOJit s4ou�d 7ioff f'xft �'?� n_ CQ mI 7�ac r/ II es 8L8 Ptak; A0210 C USf Y 411to 4 Q 'CC Ij000 , '� - 40 D ie Cl1.Ct r - e+ , CC..- .-: ' e1 • o ^ 67E/9& OQ rao =C 7 . 7 0 ' - a : ► - a H. ,utts i-ami/Y Tvus)- -i/e- AGE BUILDING CONDITION " - -a l,4 { NEW NORMAL BELOW ABOVE • FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD j-0 a s - . Meadowland DEPTH 7 House Plot BULKHEAD - Total `-'" " DOCK n, '�C R s f0, COLOR TRIM le.4 c PC 4,w lit lie it t (0 \ \\ • i I _�`--� I-4-I`j Bareas- aa VI 1 ll III NEN Ent nalmnsummannen - M. Bldg. I .21 / .2 S'> s2 -s' Extension ) 1 y. 6,-, / Po a S 2 //J 111 Extension s--,� 3 / 7 ME Ufl•�USUUR•U•NU•11 sums �a Extension //•• _ 7 4 f Foundation c o N c- Bath / Dinette Porch g :? N 1 „2,5-6/ / 2 1Basement AR R.f- . Floors 7` K. Po. _ Ext. Walls /9 s 3 Interior Finish Jr •C ! LR. Breezeway X /S' ..-r / $ r yv0 Q 7 O Fire Place pi b Heat /4 DR. Garage c s 3 Type Roof Rooms 1st Floor BR. Patio Recreation Room Rooms 2nd Floor FIN: B O. B. Dormer Driveway Total c?Si d — - .. . .-: t - (-s m ( TOWN OF SOUTHOLD PROPERTY RECORD CARD /Coo - P7/2. - / -3. =/ ��� OWNER STREET /n('6- 0 VILLAGE DIST. SUB. LOT ineec J Cads to l47 d _ 4,4, 7 FORMER OWNER N Et . ACR. J 3 la 0.800/1/1) /a V6 MaYGkIcc{ I OU Hs, Sr S W TYPE OF BUILDING if 044 Weil /Rn s � ° / t! R clog A vt A. R° 3 // SEAS. VL. , FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 4A /4 O y "' x-7.; �6/� /0/30173 SLoLo 11(ace /9. WiLibenis �o C'. re. Cour rs 7,--r.670 b & 0 U / 8 / p 7 '1/ 4473 .5,`if - 34,,,/o/Ns An.. ,6,,, C'o7>s:,,.t[ /,' (6'cro i// f-3 7/027(x(-L/ V47gf) h1/ COQ Hs, Jr. ID (OU/{s Fnuly fru 1/ /C., • AP— AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per I Value Acre it Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD d 0 Meadowland DEPTH 6 d House Plot BULKHEAD Total DOCK LEGAL NOTICE SOUTHOLD TOWN ZONING BOARD OF APPEALS THURSDAY, DECEMBER 20,2007 PUBLIC HEARING NOTICE IS HEREBY GIVEN, pursuant to Section 267 of the Town Law and Chapter 280 (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 Hail, 53095 Main Road, P.O. Box 1179, Southold, New York 11971-0959, on THURSDAY, DECEMBER 20,2007: 2:20 P.M. FRANCIS J. COUTTS FAMILY TRUST by G. Hallenbeck III, Trustee #6098. This is an application for a Lot Waiver, concerning a 16,599 square foot lot, merged as a single parcel as noted in the Building Inspector's September 6, 2007 Notice of Disapproval, under Section 280- 11A to unmerge 10,007 square feet (CTM 142-1-3.2 vacant land) for the purpose of building a future dwelling, and 6,592 square feet (CTM 142-1-3.3 with a dwelling). Location of Property: 10650 Sound Avenue at corner of Factory Avenue, Mattituck. 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: November 19, 2007. ZONING BOARD OF APPEALS JAMES DINIZIO,JR., CHAIRMAN By Linda Kowalski 54375 Main Road (Office Location) 53095 Main Road (Mailing Address) P.O. Box 1179 Southold, NY 11971-0959 #8628 STATE OF NEW YO• 410 SS: COUNTY OF SUFFOLK) Karen Kine of Mattituck, in said county, being duly sworn, says that she is Principal Clerk of THE SUFFOLK TIMES, a weekly newspaper, published at Mattituck, in the Town of Southold, County of Suffolk and State of New York, and that the Notice of which the annexed is a printed copy, has been regularly published in said Newspaper once a week for 1 week(s), successively, commencing on the 6th day of December, 2007. eta- 11.4.-n4.7 Principal Clerk Sworn to before me this I day of 1DJ2A1 ' 2007 n Ozhv CHRISTINA VOLINSKI NOTARY PUBLIC-STATE OF NEW YORK Nn '.-V06105050 Quanrie0 !n Suttolk County ,,,.,.,,. -r rocs February 28, 2008 r, Property' line, M e,aider of 28a43iant 280 d on the Build- [mg buildings,-ami (2) ,a4,2007 Notice parking area is located m an 1}est of bi,(approval_concerning proposed dental Zone District, wblj*b code ,.additionssairt lterabgns to an existing states is permitted upon appfental'a f the accessory building for use as the own- Board of Appeals under Section 280-78- err studio workshop.The Building In- B-I.The existing buildings are proposed Spector states that the following are not to be demolished.Location of Property; permitted under the Zoning Code for 1150W11600/11700 Main Road (NYS accessory buildings:(1)habitable space Route,25) and John's (private) Road, as shown in the proposed layout of the Mattituck;CTM 1223-12,2,51 and.17 accessory building, (2) setbacks. from "10:00 A.M. BREWERS YACHT the side and rear lot lines at less.than YARD#6102.RequestforVanances un- three feet, and (3) proposed dormers der Sections 280 1Sand 280 1168,based - exceeding X40% or the roof width.=Lo- on the' Building hispector',s�September cation of Property:355.Skippers Lane, 24,2007 Notice of Disapproval concern 'Orient;CTM 24-2-4._ ing aproposed accessory pavilion struc 2:10 P.M. THOMAS and MARY rare-at an amended height which will IRENE MARRON#6110.Request foi exceed the code limitation of 22 feet as Variances under Sections 280-124B and per amended plan and m a location at 280-124,based on an application for a less than 75 feet to the bulkhead,at 500 building permitand the Building In- Beach Road, Greenport CPM 43-3-2. spe-tor's September 27,2007 Notice of Zone District:Marine II. Disapproval,concerning a proposed ad- 1'0;10.A.M. PATRICIA DAWSON dition to the existing dwelling as living #6101. Request for Variances under area(mstead of garage area applied foi Sections 280114 and 280-1168, based. under ZBA#5797-2005),which addition o n the Budding Inspector's October 11, as modified will be less than less than 15 "2003'Notice Of Disapproval concern- feet on a smile side yard,at 3125 Wells =mg proposed as-built additions and al- Avenue,Southold;.CTM 70-4-10. (Cautions to the existing dwelling,which 220.PM. FRANCIS 1 CODTTS construction is-less than 75 feet from FAMILY:CRUST by G. Hallenbeck the:bulkhead and less than 20 feet on a III,Tru;tee#0098t This is an application ' smgleside yard.Location of.Property for a Lot Waiver,concerning a 16399 7940 Indian Neck.Lane,_Peconic;-also square foot lot,merged as a single-par- known as Lot 2 on the Map of High cel as noted In the Building Inspector's HbuseWoods;CTM 86-7-72. September6,2007Notice ofDisapprov- ..M25:A.M.HEINZ and BRIGITTA 0,under Section 280-11A to unmerge ROSIN'#6099 Request for Variances 10,007 square,feet (CPM,142-1-3.2 va- •under:nSection 280-124,'based on the cant land)for the purpose of building Building; Inspector's September. 21, a future dwelling,and-6,592 square feet 200,7 Notice ofTlisapproval concerning (CIM l42-I- .3 wish a-dwelling).Loca- as-built addttu4,) and alterations.to tion-of`Propertg,.10650 Sound:Avenue nby eltnstiagl si gamily dwelling with ,at corner of tgryAveppe,Mattituck h.sq, le jtl < ,. 2.40 PMP2i*AN!F ,A. .ATY `1- „vd�• a 1 +-LNC*6100 Olen oW iopertp 36'660 "k71.° s'h“ a d'fa b,d' ''" °rte•X25` gu%,`2'^BM'',t97 3:3,1 .418‘,(70.912;r8,-1 n S.�A4"' ' s Sr19Tl. Regn*t fair Vana'nu'c� ai'A a^' ax etundo1 ecyfonst28042A.acid 280-43A S -AlbtEPON R 'H j ' .s tot C based prol*te Bur(ditrg yspector's fq, ' dsdiiio ( Pit { Ia v'November4 7;iininnittet Notice pyopoal'to-rgoc t . -a w o-1)41 90,al oncen4pgaproposed posedadducins°and , "taontragons,yad andthreeprincipal tun fors'use asan a trI buildrngs+pr4bi#63,358 squats footlot. a•loft ownerspnva<t ,,a 1 70.& llieBuiIdptg!lnspectonstgtesthat: $811809rh lac ties.S" : n r lith. (1) pu{suant the Bulls'' chedule,. ; 2_2 Town Crcrek`La „ 7i sf Tone use 80000 s care:feet is alt 64-144.7- a f� ,-awed iD LIte Limited_Business (LB). ilT.'Do A,Mt a § Zone and Ptfje proposed construction N4t619 A 4 4.44 ,4 pr' (dtree tiuddmg9)'Ms not permitted on a additional yA,54', Ps !iii Tot,contavuagdess,than-240,006 square prupeseda�rf �` sfeet,for the reason that-the,proposed au.area olgt-,h*Rf t;.' e tethree buildings constitute tlree distinct `Year Yard at.4'@15'Wesr 4 tie .uses;and (also Pequashi Avenue-: da® m 4 e (2)proposed Building-#1 is not pen itl all) Cutchgg ie Ba ?x t witted itith Imear frontage,exceeding td" f)HP'T4O sa ry v at '60feet;' i z i r I: /4,, - 4gs" �rnm (3)"proposed Building not per- -258;i er ya i . 7 w 4e. .,-dt iprtted"at less than 100d'eetfrso}n a right , i ., 'a 7, ,a , 'of way ofNYS Runte 55 , Y e r s: s� d r 'k (4)pao�ppsetd,,Btrtlduag#2 t@ not per- '. '4,,,,,..-1., its, r phi„ -- s:r%'fjntted G less/gth n 75',leen}rum-`a rear i i P:Kl.tr Rdr v Pi propertyhtwvand ,r 7,g F e # (ted:abp6s fihMi 2diht lifiet3 iso not oerd na'4ees 4im e .=eotiti sia'f: -y v a'mattedatless than 20.jet from a side 280244 based on the Striding Instates lot line. a ' tic:QneberZ6'� E r av i s .: a The'Board otAppea wytlhear_all provl-concelin {aRr}. .0f,,c persons,or tiler repro t*a vedev, oto iaddttt cto', �yr& mgoebeard(aeachradkusr t5ich'aew con5tr "r12ase desnngb submit vi�aFyepskfateme�tr4s, t e'ddgree -of donoonfonnanee:a" en' 'before.the. conciusicuit :oli;*h hear-, located less than 35.feet.from the`.rear -ing.Each hearing wiltnot Start earlier property, tine. Location of Property: thandesignated above.Files are avail 2100 Naagles Dnve,l#Mattituck, CTM able fon review during regular busi-, A91-2-.8 . �- n�- s6? Hess hrs'ouani^ rzor to the day,of the ,r1 ) ,PM AtNNB` ST Pt f,S'{CI hearing. I[offhave tquestions„please"' #61104 Request for"'Vananees under do^not-hesitate to-citttact our office- Sections 280122 and$80124,.based on ' at (631)765-1809,or by email:Linda. LEGAL.NOTICE .theeBurlding.Ivspectpr's Sep, 7!4,27, Kowalslwn o4TpSouthold.nyus. St i-7THiOLI)TOWN 2007 Notice nfDrsapprovai an onryyg Dated:November 26,:2007. ZONINGB0ARD2OF APPEALS - Interpreta '( tion #5039Walz) ze ec n ZONING BeARD OF APPEALS THURSnAIVDECEIWBE1t2o,2007 ' "iAg a proposed'second-story%addition JAMES DINIZIO,JR:,CHAIRMAN PUBLIC HEARINGS and-alterations to the existingdwellipg, By Linda Kowalski- NOTICE IS HEREBY GIVEN,per- which will be an increase in the deme 54375 Main Read(Office Location) suant to Section 267 of the Town Lav( df noncoufornuty when the rear yard 53095 Main Road(Mailing Address) and Chapter 280(Zoning),Code of the and•fiont yard setbacks are less.-than. - P.O:Box 1179' Town of Southold;the following public 35 feet Also proposed are additions.at Southold,NY 11971-0959 hearings will he held by the SOUTH- less than.the,00de required 35 feet rear 8628-1T 12/6 - OLD TOWN ZONING BOARD OF setback-and front setback(newnoncon - _-- _-- APPEALS at the Town Hal) 53095 tormities)under the code requirements. Main Road, PO Box-1179,Southold, Location of Property:1o25Cedar Road, New York.119710959,onTHURSDAY Southold;CTM 787.35. DECEMBER 20,2087: 140 P.M. SOUTHOLD” PARK 930 A.M. END OF THE ROAD, DISTRICT#6105.Request,for a Vani-. LLC' #6013 Request for Variances ance':under Section 280-14, based'on under.Sections 280-49 and.280=78B-I. the Building Inspector's November 9; based on the Building Inspector's No- 2907.amended Notice..of Disapproval ',ember 19, 2007 amended Notice of concerning proposedadditions and al- Disapproval concerning proposed con- terations to an existing'.building at less struction of two buildings (with retail, than the code-required mumnum of 60 office:and bank space m this B-General ;feet from the front lot line Location Business'Zone District The reasons for of Property 5345 South Harbor Road,. disapproving the building permit ap- Southold;CPM 87118.7 plication are:(1) one of the two build- 1:50 PM KINGA P.CRARY#6108: trigs will be less than 25 feet from the Request for Variances.under,Sections' #8662 STATE OF NEW YORK) SS: COUNTY OF SUFFOLK) Karen Kine of Mattituck, in said county, being duly sworn, says that she is Principal Clerk of THE SUFFOLK TIMES, a weekly newspaper, published at Mattituck, in the Town of Southold, County of Suffolk and State of New York, and that the Notice of which the annexed is a printed copy, has been regularly published in said Newspaper once a week for 1 week(s), successively, commencing on the 10th day of January, 2008. errS Principal Clerk Sworn to before me this ID day of : , � 2008 11:25 A.M. ROBERT and ERIN 1 ��( LC(A7)7391 O 1 t / :1 EI DICKERSON #6120. Request for a l+ I I �f f� l/V :/ v Variance under Sections 280-122A and CHRISTI VOLINSKI 280-124, based on ZBA Interpreta- tion #5039 (Walz Application) and the NOTARY PUBLIC-STATE OF NEW YORK Building Inspector's November 16,2007 No. 01-V06105050 Notice of.Disapproval concerning pro- Qualified In Suffolk County posed additions and alterations to an existing dwelling,which new construe- Commission Expires February 28. 2008 tion creates a new nonconformance or Southold, New York 11971-0959, on alterations to the existing single-family increase in the degree of nonconfor- THURSDAY.JANUARY 24 2008: dwelling, which new construction: (a) mance when located less than 50 feet 9:30 A.M.CHARLES HILL#6111. will be less than 75 feet from the bulk- from the front lot line and less than 15 Request for a Variance under Section head adjacent to Cutchogue Harbor and feet on a side yard.Location of Proper- 280-15, based on the Building Inspec- (b) will exceed the code limitation of 1600 Alvah's Lane,Cutchogue;CTM tor's November 5,2007 Notice of Dis- 20% maximum lot coverage. Location 102-4-8.1. approval concerning an as-built acces- of Property: 1165 Old Harbor Road, 1:00 P.M.MILDRED ANN DIACK son'shed in a yard other than the code- New Suffolk;CTM 117-3-8.4. #6109. Request for a Variance under required rear yard,at 655 Lake Drive. 1:50 PM. RICHARD TRIPPTREE Section 280-116A.2.based on the Build- Southold;CIM 80-3-20. #6118. Request for a Variance under ing Inspector's October 11.2007 Notice 9:40 A.M. DEBRA LACHANCE Section 280-124,based on the Building of Disapproval concerning the loco- #6133. Request for a Variance under Inspector's September 7, 2007 Notice tion of a dwelling at less than 100 feet Section 280-124,based on the Building of Disapproval concerning a proposed from the ordinary high water mark of Inspector's November 14,2007 Notice porch addition which will be less than 40 the Long Island Sound,at 1840 Lcelon of Disapproval concerning a proposed feet from the front lot line,at 910 Wa- Drive,Southold;CIM 58-2-11, addition to the existing single-family basso Street.Southold;CIM 78-3-511.1. 1:20 PM.1690 BAYVIEW ASSOCI- dwelling, which is proposed less than 2:05 P.M. FRANCIS J. COUTTS ATES #6117. Request for a Variance 10 feet from the side yard,less than 25 FAMILY TRUST by G.Hallenbeck III, under Section 280-116B, based on the feet for total side yard setbacks,and less Trustee#6098.(Continued hearing).Re- Building Inspector's November 5,2007 than 35 feet from the front lot line.at 630 quest for lot Waiver to Unmerge.Loca- Notice of Disapproval concerning pro- Ruch Lane,Southold;CTM 52-2-26. tion of Property:10650 Sound Avenue posed alterations to the existing first 9:55 A.M. ROBERT and MARY at corner of Factory Avenue,Mattituck. LEGAL NOTICE floor, new second-floor addition over SOUTHOLD TOWN ZONING the existing first floor,which new con- for KATE DIG under e#6115.Request CTM 142-1-3.2 and 3.3. BOARD OF APPEALS struction areas will be less than 75 feet for Variances under Sections 2811-15B, 2:20 PM. KINGA CRARY #6108. THURSDAY,JANUARY 24,2008 from the bulkhead adjacent to Goose 2811-I cto 280-124,based on the Building Requests for additions and alterations PUBLIC HEARINGS Creek,at 1690 Bayview Road,Southold; Inspector's October 15,2007 amended to ry building with:1)proposed NOTICE IS HEREBY GIVEN, GYM 70-12-37. Notice of Disapproval concerning a habitable space for studio workshop as to Section 267 of the Town 1:35 P.M.SANDFORD and ELI'ZA- proposed accessory garage on this shown in the proposed layout of the ac- pursuantLaw and Chapter 280 (Zoning),Code BETH FRIEMANN #6114. Request 16586 square foot lot.The new garage cessory building,(2)proposed nonconand - of the Town of Southold, the follow- for Variances under Sections 280-1166 is proposed at 22 feet in height in a lot forming setbacks from the side and rear ing public hearings will be held by and 280-124,based on the Building In- line, at less than 20 feet from the side lot lot lines at less than three feet,and(3) the SOUTHOLD TOWN ZONING spector's amended November 26,2007 • line,and less than 35 feet from the front proposed dormers exceeding 40% of BOARD OF APPEALS at the Town Notice of Disapproval concerning pro- Drive),lot line, ut hog000 Oak CTMSt13t (at Pierce 35th5 roof SkipperswiLane,LocationOrnt of M 2Pro4--4. Cutchogue; 1 E.36. 3v:0) PMOrMe CPM (and a d 4. Hall,53095 Main Road,P.O.Box 1179, posed additions, swimming pool, and 109)5 A.M. RUSSELL E. PLAN- 3:011 P.M. EDNA McNULTY (and ITZER #6112. Request for a Vari- JOHN C. DILLER and HOLLY M. ance under Section 280-14. based on DILLER) #609(1. Request for a Vari- the Building Inspector's October 30. ante under Zoning Code Section 2007 Notice of Disapproval concern- 280-18.based on the Building Inspec- ing proposed alterations to an existing tor's July 26,21)07 Notice of Disapprov- third-story living area in a single-family al which states that the Bulk Schedule dwelling, for the reason that the Code requires a minimum lot area of 40,000 limits construction to 21/2 stories in square feet,and the area of CTM Parcel height.Location of Property:South Side 1000-145-1)2-1.5 will be reduced from of Ocean View Avenue,Fishers Island; 20,877 square feet to 20,093 square CTM 9-11-3.1. feet.creating a greater degree of non- 10:25A.M-JOHN CORBLEY#6119. conformity,with a lot line change to en- Request for Variances under Sections large CTM Parcel 1000-145-02-1.4 from 280-122, 280-124, based on the Build- 22,1.51 square feet to 22,936 square feet. ing Inspector's October 4,2007 Notice Both parcels are currently nonconform- of Disapproval and Zoning Code Inter- ing in lot size in the R-40 Low-Density pretation#5039(Walz)concerning pm- Residential Zone District, located at posed additions and alterations to the 160 and 240 Great Peconic Bay Boule- existing single-family dwelling, which yard,Laurel. new construction will create a new non- The Board of Appeals will hear all conforming side yard setback,and will persons,or their representatives.desir- create an increase in the degree of non- ing to be heard at each hearing,and/or conformance.when located less than 15 desiring to submit written statements feel on one side yard and less than 35 before the conclusion of each hear- feet for both side yard setbacks(total), ing.Each hearing will not start earlier at 680 Mason Drive,Cutchogue;CTM than designated above.Files are avail- 104-7-3. able for review during regular business 11:05 A.M. GARY GUJA #6116. hours and prior to the day of the hear- Request for Variances under Sections ing.If you have questions,please do not 280-124 and 280-242A, based on the hesitate to contact our office at (631) Building Inspector's September 17,2007 765-1809,or by email:Linda.Kowalski@ Notice of Disapproval concerning pro- Town.Southold.ny.us. posed additions and alterations to the Dated:January 3,201)8. existing single-family dwelling, which ZONING BOARD OF APPEALS new construction will create a new non- GERARD P.GOEHRINGER, conformance or increase the degree of CHAIRMAN nonconformance with setbacks total- By Linda Kowalski ing less than 35 feet on both side yards, 54375 Main Road(Office Location) at 372 North Drive, Mattituck: CTM 53095 Main Road(Mailing Address/ • ZONING BOARD OF APPEALS TOWN OF SOUTHOLD: NEW YORK X In the Matter of the Application of 2prac45 T COOTis -FQmt \yT}s} AFFIDAVIT b\k 6-, t I I:nnbea _ tit ,: OF MAILINGS (Name of Applicants) CTM Parcel #1000- - - X COUNTY OF SUFFOLK) STATE OFNEWYORK) I, K y C-taforA residing at I4Orei�((e„ Ave Med-terA N H n 7b 3 , New York, being duly sworn, depose arttl say that: On the .204 day of /Um/ t r b es, 261:71 , I personally mailed at the United States Post Office in l.Lv PP wv e New ork, by CERTIFIED MAIL, RETURN RECEIPT REQUESTED, a true copy df the attached Legal Notice in prepaid envelopes addressed to current owners shown on the current assessment roll verified from the official records on file with the` ()Assessors, or( )County Real Property Office ,for every property which abuts and is across a public or priva;o street, or vehicular right-of-way of record, surrounding the applicant's property. )4 / ('ignature) Sworn to before me this 2° day of 7tew...hs' , 200 Otey` "I- X '1 , _ JOAN M.FlCHTNER `�^""`�`�� Notary Public,State of New Yak In (Notary Public) �a1ified No. 01E1450I8363unty 9 Jo/ Commission Expires October 91, PLEASE list, on the back of this Affidavit or on a sheet of paper the lot numbers next to the ovnner-names-and-addresses-fvr_ hich notices were ma11r'Tlian c ou. • • • Rhoda and Robert Marchica 142-1-2 P.O. Box 201 Mattituck, NY 11952 Steven and Jeanine Racanelli142-1-4 J Heed c � Sp�,,4 �9it 7cr df 84 Hudson Road A diNstetik qc la 91'2- Bellerose Village, NY 11001 Jennifer Lee 142-1-16.1 10690 Sound Avenue Mattituck, NY 11952 Walter L. Dohm, Jr. 142-1-16.2 Knita Dohm P.O. Box 977 Mattituck, NY 11952 John Christina 141-3-6.3 91-08 159th Avenue Howard Beach, NY 11414 Paul and Mary Michalecko 141-3-3 P.O. Box 133 Mattituck, NY 11952 Thomas and Barbara Mercier 122-2-15 P.O. Box 1423 Mattituck, NY 11952 • Complete items 1,2,and 3.Also complete A. Sign ^ - et - - - item 4 if Restricted Delivery is desired. 00 allgi Mrti.eWZiTII ' • Print your name and address on the reverse en.. /.i/ yr?.i .tildliat1/f_\I US]41:1 so that we can return the card to you. B. Received by(Printed Name) O (e.„-s is Mail OM • • Insurance Covera•e Provided • Attach this card to the back of the mailplece, Q- or on the front if space permits. •-• For delivery information visit our website at www.us•s.co-r D. Is delivery address different from Iter }( p 1. ArtTO "Article Addressed to: If YES,enter delivery address bolo OIl T IIF 1F11? L USE Paul rnA Mary Michalecko 1:13 P.O. Box 133 rq Postage IIIIIIIIIII 511t Mattituck, NY 11952 o Cedified Fee �� 16 Postmark CI Return Receipt Fee 11.11111411V�'v n 0^O,Hire 3. Service Type O (Endorsement Required) G G (; 14$Certified Meg 0 Bllpnee Me Resected nt Rrery Fee) Maw C (Endorcted D livery e e ❑Registered Zl Return Rao O^ ❑Insured Md 0 C.O.D. al Total Postage&Fees , n17 4. Restricted Delivery/(Odra Faa) - 2- AttldeNumber o Paul & Mary Michalecko (Transfer from service label) 7005 0390 0001 1892 4902 oM1 &feetptoi PO Sox No.;P•0. Box 133 PS Form 3811, February 2004 Domestic Return Receipt City,State,ZIPH attituck, NY 11952 S r_� PS Form 3800.June 200 For delivery information visit our websiteat www.usps.com„ S F• �,y,,,,u,meuon visit our website at ww®w.u�sps.comk, ON-, FL'F' R{re �,' „ i pN-, MOP FICIAL USE $ 4Q•4i " 'NC co IA Postage rR Postage $ $0.41 07`" 'NC 0 Certified Fee Query.'' postmark t,9 Certified Fee �S. 4, 0 N $:.615 k, Return Receipt Fee , 2 U erit':. C Return Receipt Fee d Postmark �\� (Endorsement Required) ��� NOV p (Endorsement Required) 12.15 a Is% `12 Resected nt Required) Fee Resected DelFrery Fee 0 Dom-. (Endorsement Requlretl) 0 (EndoreemeM Required) 4'x).';0' m $ - m y C Total Postage&Fees ---'- - C Total Postage a Fees $ 45.21 11l : To V-1 'TMf o on. gmilieiven and Jeanine BAC1Slt31t] o n and--3axbaxa-Mex-ciex orP09ox No.• r` or PO Sox "P.O. Box 1423 84-_Hods n..Bread City,snare,zips 11001 sm e,paw Bellerose Village, NY See ersetor Instructions I a' ttituck, NY 11952 PS Form 3800.June 2002 PS Form 3800.June 2002 See Reverse for Insire,ri,n I U.S. Postal Service,, U.S. Postal Serviceru r CERTIFIED MAIL, RECEIPTco Cron. CERTIFIED MAILr•, RECEIPT (Domestic Mail Only;No Insurance Coverage Provided) (Domestic Mail Only;No Insurance Coverage provimded) For delivery information visit our website at www.0 ps'•°n'^ For delivery information v our websit w sps.co ru L ; ro h T TIF i tr 'itI 1 1 �� { o ...ii m Postage '' __` y4" IA Postage $ 06 ] a `, Inn,101 Mr 1. �\ � P� a Certified Fee L IA Certified Fee i�`� Postmark O Fee ® CiV 2 Q ?l C O (EndorsementsemReceipt equired) 'tri oa 1 C ReNm Receipt Fee - Here 0 (Endorsement Required) + U Restricted Delivery Fee O Restricted(Endorsement Required) • (Endorsement Required) 0-' mm ..�. O Tole/Postage&Fees $ ¶_.. 1 1 1,;' '. 00 C Total Postage a Fees O , r o UP ° Walter I.. Dohm, Jr. I{Nna ta-]1D11IA o Rh. -- ..red-_Ro12e 1--Marsh ca-----------• o ----- r Box 201 N Saeed Apr. a; or Po Sou No. P.o ° 2°hoz No. ----- ----------------- P-.-O.--$RX--97Z .............................................................. - --- cae.State.ziPw c seieZP+4 NY 11952 Mattituck, c"ene•,erseierinatrnmren= 0e • PS Form 3800,June 2002 See Reverse for Instructions p5 Form 3800.June 2002 U.S. Postal Servicer, ru CERTIFIED MAIL,. RECEIPT U.S. Postal Service,' co (Domestic Mail Only;No Insurance Coverage Provided) CERTIFIED MAIL„, RECEIPT l S For delivery information visit our website at www.usps.comr, 0' (Domestic Mail Only;No Insurance Coverage Provided) Fite rE cr.71. ri I 1 '+66 A( err..". For delivery information visit our website at www.usps.com t,9 Postage =Mr- '1'7C3rr ru H [I ,S�!" l 1 g w•'_; t,'9 1 to Codified Fee =EN Nov 21slErtlKK co rl Postage (P ,,.4 q C ReturnemntRReiptquired) Fee _ Here C _ C (Endorsement R livery e e ra Certified Fee 2pa�r,�r�k Reetr Delivery Fee C Return Receipt Fee f{r»g QC-. (Endorsement Required) USPS a (ErMoreemnt Required) • m : 2-0e Restricted Delivery Fee , O Tonal Postage a Fees $ ,;‘,L,.2-1- =t.'�''1f`�•-' (Endorsement Required) cr IMPS"1 To m o Jennifer Lee C Total Postage BFees $ _ i 111 t + M1 baees Apt.Aix; 1+7 r "P"°"Na 10690 Sound Avenue C .Joetn Christina = Mattituck,City,tateCin_ Street,Apt.No.; NY 11952 orSOBox No. 91-08 159th Avenue FS Form 3800.June 20,x2 City,State,ZIPN Howard Beach, NY 11414 PS Form 19111) JIM) ?919P ^"Here,He for Instruction, r marl 031100 aY alol'paeppy Memae 11LL 40 JIiOMl 31LL O13d013A113 AO ell 1V!MOUS 3OV13 SENDER: COMPLETE THIS SECTION ---.- )N DELIVERY • Complete items 1,2,and 3.Also complete A. Signature _ itemP4 if Restricted an Delivery ddre is desired. X 1 ! Ib / /j cn ` " nt • Print your name and address on the reverse �[�' l�1 a - Atldretssee so that we can return the card to you. B. Received by(Printed Name) C. Da of Delivery • Attach this card to the back of the mailpiece, // Zf/ or on the front if space permits. /e, D. Is delivery address different from item 1. 0 Yes 1. Article Addressed to: If YES,enter delivery address below: ..�NO Rhoda and Robert Marchica P.O. Box 201 Mattituck, NY 11952 3. Service Type • LI Certified Mail 0 Express Mail 0 Registered El Return Receipt for Merchandise 0 Insured Mail 0 C.O.D. 4. Restricted Delivery?(Extra Fee) 0 Yes z. Article Number 7005 0390 0001 1892 4858 (Transfer from service label) - ------------------- --- PS Form 3' . Fa r in D4 Re urn R-r-int 102505-m-M-1540 mel ammo le 0104'Y31g0V MUM lie 31LL 40 DIEM Mit 01341013Ae3404011Y tl3N3US 3OYIA SENDER: COMPLETE THIS SEC IION ..vn.ric r c .nw aw,'ON ON DELIVERY • Complete items 1,2,and 3.Also complete A. Signature 44t----- /� item 4 if Restricted Delivery is desired. x i Qe ( ,R /,( jt— 0 Agent • Print your name and address on the reverse J��ti^�L �(/"D Addressee so that we can return the card to you. Br,Reqeived by(Prip(ed Name) C. a of livery • Attach this card to the back of the mailpiece, fhrf��Y111 \ W in. (I a r o 1 or on the front if space permits. `vf' t U� /U� D. Is delivery address different from item 1? 0 Yes 1. Article Addressed to: If YES,enter delivery address below: 0 No WAlter J. Dohm, Jr. Knita Dohm P.O. Box 977 Mattituck, NY 11952 3. Service Type • El Certified Mail 0 Express Mall 0 Registered t Return Receipt for Merchandise 0 Insured Mail 0 C.O.D. 4. Restricted Delivery?(Extra Fee) 0 Yes 2. Article Number (Transfer from service label) 7005 0390 0001 1892 4889 SENDER: COMPLETE THIS SECTION COMPLETE Inis ae..RON ON DELIVERY • Complete items 1,2,and 3.Also complete A SjQQn a�zure r. item item 4 if Restricted Delivery is desired. x(r law„IG0 Agent • Print your name and address on the reverse i I�/ AEI-Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery • Attach this card to the back of the mailpiece, -St):1 a 11 R 1 c.,-Ii^"it I(-z _c or on the front if space permits. D. Is delivery address different from item 1? 0 Yes 1. Article Addressed to: If YES,enter delivery a.. - below: 0 No John Christina // s�„-e.sb 91-08 159th Avenue /^M,A.edsb ill ; so 1£ ! i Howard Beach, NY 11414 i cr., R• 62 e t C? , — mice Type . S?-. a 4,ØUtflegistered l Certified M. 4n I Exp - c-r ; - r'kin 4 iptior Merchandise -” HO4' ,.O Insured Mail ' - . - 4. Restricted Delivery?(Extra Fee) 0 Yes 2. Article Number (Transfer from service 1360 7005 0390 0001 1892 4896 no c_...,QR11 cohnion,'rind Domestic Return Reeeiot 102595-02-M-1540 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY • Complete items 1,2,and 3.Also complete A. ature p item 4 if Restricted Delivery is desired. x j //` /�yI,,A/l; ❑Agent • Print your name and address on the reverse L(,� Vl�" ,i 0 Addressee so that we can return the card to you. - i by Pr'r)te4Nfarrv) C. Date of Delivery • Attach this card to the back of the mailpiece, i L��, tl/1, �(? r ,\��.1, or on the front if space permits. Yhv-1 1. [� l/ I. Is delivery address different from item 1? 0 Yes 1. Article Addressed to: If YES,enter delivery address below: 0 No Thomas and Barbara Mercier P.O. Box 1423 Mattituck, NY 11952 3. Service Type I [ Certified Mail 0 Express Mail 0 Registered El Return Receipt for Merchandise 0 Insured Mail 0 C.O.D. 4. Restricted Delivery?(Extra Fee) 0 Yes 2. Article Number (Transfer from service label) 7005 0390 0001 1892 4919 PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 1 Lawrence Eric Davidow DESS Harry A.Davidow Lawrence A.Siegel (18904959) Steven H.Stern* Refired Michelle Jablonsky DAVIDOW, DAVIDOW, SIEGEL & STERN, LLP Wallace E Davidow Samford L.Davidow Regina E.MacKay Counselors at Law•Original Firm Founded 1913 Martin S.Glass Oded Ben-Ami Nassau Office: One Suffolk Square • Suite 330 • 1601 Veterans Memorial Highway • Islandia, New York 11749 666 Old Country Road Of Con,isei Tel (631)234-3030 • Fax (631) 234-3140 Suite 810 Gina Raio Bitsimis Garden City,NY 11530 Anne-Marie Monahan Website: www.davidowlaw.com Tel(516)393-0222 Robes E.Pipia Fax(516)228-6672 *Admitted to Florida Bar Ens!End Ohre: 13105 Main Road December 13, 2007 PO Box 344 Mattituck.NY 11952 Tel(631)298-96X) Fax(631)761.0370 Town of Southold Southhold Town Zoning Board of Appeals Town Hall Annex Building 53095 Main Road PO Box 1179 Southold, New York 11971-0959 Re: Francis J. Coutts Family Trust by Geoffrey Hallenbeck III, Trustee #6098 Location of Property: 10650 Sound Avenue, Mattituck, New York Dear Sir or Madam: Enclosed please find the following documents with respect to the above referenced matter: I. One([)Green Signature with notice of unclaimed mail. The Southold tax office advised me they have no other address for the addressee on record. Very truly yours, DAVIDOW,DAVIDOW,SIEGEL & STERN,LLP \USAF I A I l Michelle Jablonsky MJ/sing DAVIDOW,DAVIDOW,SIEGEL&STERN,LLP Counselors at Law•Original'Firm Foamed 1913 One Suffolk Square•Suite 330• 1601 Veterans Memorial Highwa7 Islandia,New York 11749 7005 0390 0001 1892 4872 --- �3 TO 5 PTs.. E PRI/ — HUPPRUN{Yf a DNCLAImcn^f`L $f9 POSTAL SIR V,CFAP/ o� $521 �'}. ,^ Jennifer Lee 0000 1-1952 - 0009,557-I6 �� a , .]0690 Sound Avenue Ct eN At. ti P1 fee nib LAI Fell I II W d un L. c a ° 0 w •oz Hs • icy oo `95 - z u li li wl In a ulu IIlm IiIIII II illu..wln__n__ ____ •••----•T- I- ... . I• • Steven and Jeanine Racanelli 142-1-4 1480 Factory Avenue Mattituck, NY 11952 I THIS WAS A SECOND ATTEMPT TO DELIVER NOTICE AS THE FIRST WAS NEVER CLAIMED V.S. Postal Service,M -E CERTIFIED MAIL!, RECEIP n1 (Domestic Mail Only;No Insurance Covera ovided) n- For delivery information visit our website at www.usps.com::o ru ---i co • °�! T rl Postage $ r �': :l' '7 r9 Certllled Fee $2.65 (':{ O / mime(0 Return Receipt Fee `'Here O (Endorsement Required) /.. ▪ MADelivery Fee $^_;_it Q. (EMory9mem Required) l: rn - O T Postage&Fees $ a5.38 l'711.1720$7 O , t G teven and Jeanine Racanelli - o • -or PBox No.'." Factory 1480 Avenue City,State,ZIP+4 Mattituck, New York 11952 IPS Form 3800,June 2002 See Reverse for Instructions i =1 1 1 1 Lawrence Eric Davidow I i DSS Harry A.Davidow Lawrence A.Siegel _ (1890-1954) Steven H.Stem" Retired Michelle lablonsky DAVIDOW, DAVIDOW, SIEGEL & STERN, LLP Sa .DavdowNo F Regina E.MacKay Counselors at Law•Original Firm Founded 1913 Martin S.Glass Gded Ben-Ann Nassau Office: One Suffolk Square•Suite 330•1601 Veterans Memorial Highway•Islandia,New York 11749 666 Old Country Road Of Counsel Tel (631)234-3030•Fax (631) 234-3140 Suite 810 Gina Raio Bitsimis Garden City,NY 11530 • Anne-Marie Monahan Website: www.davidowlaw.com Tel(516)393-0222 Robert E.Pipia Fax(516)228-6672 'Admitted to Florida Bar November 20, 2007 East End Office: 13105 Main Road PO Box 344 Mattituck,NY 11952 Tel(631)298-961 Fax(631)761-0370 Steven and Jeanine Racanelli 84 Hudson road Bellerose Village, NY 11001 Dear Mr. and Mrs. Racanelli: Enclosed please fmd a Legal Notice regarding a hearing to be held on December 20, 2007 at Town Hall with regard to the following property located at 10650 Sound Avenue at corner of Factor Avenue, Mattituck. I also enclose a copy of the site plan which highlights the property stated above. Very truly yours, Davidow, Davidow, Siegel & Stem LLP tI1 1/4 Michelle Jablons • MJ/smg =i Enclosures final--n-Ilr.S•Zy-prrr.rr`. - DAVIDOW,DAVIDOW,SWGEL&STERN,LIP11 HIE 111 IIIII1 1 111 • Counreion at Law•Original Finn Founded 1913 One Suffolk Square•Suite 330• 1601 Veterans Memorial Highway — --- — Islandia,New York 11749 7005 0390 0001 1892 4869 U.S. POSTAGE PAI HRUPPR78$.NY..ic NOV 20. 07 T nares AMOUNT vwrrau I , vosrer sexmcr I'I $521 A 0 INSUFFICIENT ADDRESS 0000 11001 0009557-I6 got, Or 0 ATTEMPTED NOT KNOWN ❑ OTHER IP 11i _ _ • 0 N SUCIIr�y�,r ' S 0 NOT0 T 1 sup RETURN TO SENDER elie. • , rrr- ,. „.,k /.4.2 dr 1 UNCLAIMEDififth5 i )9d Noce all %:2k,: 7 � � I Inman nIl•IMinlimmimiInmlmmmumma MN III I I III I I I UM II/I111iiississammis• nni I . . ... ..... M1111111111=1•1111111111111111•11•11111511111E1 1111 MD1 MIESI I 1111111 I 1111M1 111 MI=1 0-0 V 21ItU3J •---------- --- -------- 3NI1031L00/V 010i'SS3e00V Naruaa 311140 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY • I • Complete Items 1,2,and 3.Also complete A. Signet item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse 0 Addressee SO that , - n return the card to you. B. R: 'wed by(Printed Name) C. Date of Delivery ' ■ Atlee • to the back of the mailpiece, or o, if space A t. .. .: ..._..,. .-delivery address different from ttem 1? ❑yes If YES,enter delivery address below: 0 No St= -n e Rai nelli 8 , ,iudsot ,. B lerose _e, NY ' 1001 3. Service Type IN Certified Mall ❑Express Mail . ❑Registered S]Retum Receipt for Merchandise ❑Insured Mail 0 C.O.D. 4. Restricted Delivery?(Extra Fee) 0 Yes 2. Article Number (Transfer from sect I®bel) N 7 005 . 0390 001 1892 4865 PS forrtt.3811,February 2004 Domestic Return Receipt 102595-02-M-1540 ZONING BOARD OF APPEALS TOWN OF SOUTHOLD: NEW YORK X In the Matter of the Application of AFFIDAVIT Qa{.fie g l tort bek OF SIGN POSTING (NamY of Applicants) Regarding Posting of Sign upon Applicant's Land Identified as loon- /qZ,, - t_3^_z x COUNTY OF SUFFOLK) STATE OF NEW YORK) /�� I �v g 6 siding at 2-700 CQr+r A•tefeo6t Pot 1 ' k {'�: i-yc-k /, New York, being duly sworn, depose and say that: On the j"day of Cern,bet 2.°07, I personally placed the Town's official Poster, with the date of hearing and nature of my application noted thereon, securely upon my property, located ten(10) feet or closer from the street or right-of-way(driveway entrance)— facing the street or facing each street or right-of-way entrance;* and that I hereby confirm that the Poster has remained in place for se en da riot to that date of the subject hearing date, which hearing date was shown to be 20 0 fidasey (Signature) S om to before me this itt day of ,QMb f , 2001 MELANIE DOROSKI r 4 NOTARY PUBLIC,State of New York A A -s 4 ' No.01004634870 (Notary blit) Qualified in Suffolk County Commission Expires September 30, 1 *near the entrance or driveway entrance of my property, as the area most visible to passersby. 11 • • APPLICANT • • TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethicsprohibits conflicts of interest on thepart of Town officers and employees. The purpose of this form is to provide information, which can alert the Town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: H a l fen be c K) co irev by (Last name, first name, middle initial, unless you are Applying in the name J of someone else or other entity, such as a company. If so, indicate the Mi ched(c other person or company name.) Tab (onsKj , NATURE OF APPLICATION: (Check all that apply.) Tax Grievance Variance Change of Zone Approval of Plat Exemption from Plat or Official Map Other If name�the activity: Waiver to un me r ge pro I2Clly 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 7/ 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: PI Orli Yl �t D Title or position of that person: {Jtad or Poore. Dry a "en ti Describe that relationship between yourself (the applicant) and the Town officer or employee. Either check the appropriate line A through D (below) and/or describe the relationship 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 than 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 M 4 r ti r1 F!tit-I ry is IVU( S.e cCn d CCoS(r1 Submitted m day"• / 1 2 Al SSign N re: �� /'� e: t. e0 . 'L(,,Litbecn7 e. a _ • ... scu. .. ., NOTICE c� COUNTY OF SUFFOLK © i 'a. OLO "6.65 -----T— — eim,ti e Wim.o. TATER ..,,E,.,, ••' a.�@„,PANT . MF E OP tip, �' Red Property fax Service Agency r SOU7N SECTION NO 56/16 crunir Canty Stu Rxsreoge r n94t . 141 „,..E x c / ( r�--Ar P ,n "Ma* !/1 L . 7 >� //GIJC / -3 & ' / 3 1000 PROPERTY MW 'foil' a 151x2-i- st- 190z—/— /4•� /4/ - 3 — 3 D 10 4 SVA 3 fr �— Z ,. At 3 % 1 VC4, .o,04 . iiii �fi ,,H. ' S4. 9L I, V 411400, Add-d-A � . t?' "4411104,,,t-l:t' •40011 los 1 • eF T A 094. /fir i J / moo -- NOTI E O_ ” ,.0,,. — .. ,....,.�.,.,:--6..-_ ,...,� ' .na..m '�..,... ax .cnnu.� w R COUNTY OF SUFFOLK CD K '°°'" SWTHOLO _ SECTION NO w. t. Red Property Tax Service Agency r amaa MON Canty Center rm.t.a%IIT MI x .t..R 142 a--e 6. o M�a 1000 PROPERTY WA minx NR...... I TOWN OF SOUTHOLD PROPERTY RECORD CARDd .- loon —/i42 --/— 5.3 ,/ OWNER STREET /6 7 Q VILLAGE DIST.' SUB. LOT ritilICPS a. n^Id. FORMER OWNER Nff t E -� ACR. �OLfT"(- -VG(Yr (i,-,, ID°i-( ti-1 0.400 S W , TYPE OF BUILDING jr. ‘ (01 IA1177s C1 `-Yu 550 /^ /' 7.- =�' RES. g/0 SEAS. VL. FARM COMM. CB v MICS. Mkt. Value N LAND IMP. TOTAL DATE REMARKS O Q 7n) ,/s.._0 i V3/40 -Lal ber2o9C° Z e 3 6 0 02../ � J t2.2 o t1 / e/W n toj5)/T3 . 1_iber rs ,I p ii • 'J9cc 2 ;0.C< 3/�4OC >/iy/8 sb o4) 7 _ Cow hi e1ed ,? e b,.e(c. .i _.J^r'0 rY99" I co -Jp6"G ���.I.yn ��/�OJ •-i✓„ ? 4JOar, - ; ' SbPUi(C/ / l ' ' , n, „ f . ),.,.: i,_ 07. ,/ ' 4. �/ii /856_8 f2. CausfakzY PAT° h CA e,�x Y f Ijc.)0o, 0 <400 `6 Char , r� e e e a_ - -, b — 671E`9 ‘y , ecc:cfi re,y 74fl o4-1_Ia477)g3 '- Cowls Io Chu #s i n/y Twos). -'7/c- AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE • FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD J22 ( ... Meadowland DEPTH r House Plot BULKHEAD Total '°� DOCK * ;; f/ COLOR TRIM !/� /t;*- r / C -.\\\., -. . i \\ � ` I I Wr • " 3 :_� ,/ iso cf M. Bldg. .2r ( .2 �'& sZ -5" ; Extension la I b- / go / O f 3.0 0 2 //3� g Extension � 47.e76,.. / .. - 3 / 7 - - Extension �— r 9 Foundation c G N c_ Bath / Dinette %arch tL 2,..444/ /4._;f1 ; /4, X' I4 a ;31 n / 2 / Basement p,q p_r- Floors t K. = Ext. Walls S Interior Finish .a a7✓ LR. =feezeway 9 x ib— — / 3 s, yv0 a 7O Fire Place D Heat DR. age 3 �'f !o e 3 8 Type Roof t Rooms 1st Floor BR. Y Recreation Room Rooms 2nd Floor FIN. B r'• .; k„ Dormer Driveway ` s.= • 1 1410 TOWN OF SOUTHOLD PROPERTY RECORD CARD -2 „ 1000 - / ./p - / -3.2 OWNER STREET f& t 0 VILLAGE DIST. SUB. LOT Frances ces J . etas iiimly sr? , ,--A., n/ ://re .. ,4., / FORMER OWNER SowNA AVE E MGlyck1cc ACR. l3 Iaa °UTIs, jr, , S W TYPE OF BUILDING o • W' / �,m, s r . I £ .f ,- IA a ro ,e y A v 2ES. 3 // SEAS. 4 VL. F9- FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS WO a 2/ e"' ' —73. ‘ /0/30 /73 $'oL0 '°goo°. R. WIL1m ns To C. tP. 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"' , 'a °r L; ,un `e r `Ei n` ' y`�,T;r>a _ 2g.. F t Ix ti:i a ..� ps k � �� Hrs k { F .k r�ma $ � .9d w ', ` a9,?:,- ..'... .. r.> ,cwt='r.{e:,bx ` "A.ai"s+e ,11.. .•. ,.-:::,z F''4 ' g'; " u., .... Prints the screen _ _ _-.._._._ — . . 14,4„„,,,40:4'4'1*: � N e#. » session A-[24:x G4] Inbo<-MirraGk 4ut.1, 4 Search Results-Lasa... C k.F'S Version 4-[site... .1: mttv.w. Y[sc ,uw O - Yww secia / % I it l'a, ., . \ Sl y5• A\I , i -, % sem' �:� 4y YY ESQ . n' , M4 NO ► • s /s. s a 3/ / / // // / Gym —+— �.. n (210 ru O E — _I ,,,w :75:75:75. •,'=:'" ° 7,- NOTICE COUNTY OF SUFFOLK e fled Property Tax Service Agency I r —_NI on. ____D SECTION NO — w E�., µ IT. Y Y „Mfl <s 14 2 Y ` ...- _ „nun PROPERTY YAP 1000 KT W. Lsga P _ NW ff` i4 _ re a �. A : T !. For additional Information or a demonstration of this prod u ca " •e - "` `` Y- r� .wr �c + • • Tradition Title Agency, Inc. Agent for First American Title Insurance Company of New York 370 Old Country Road, Garden City, N.Y. 11530 (516) 742-88400 Fax (516) 294-5227 • Tradition Title Agency, Inc. Agent for: First American Title Insurance Company of New York does hereby certify to: TOWN OF SOUTHOLD THAT it has caused a Search to be made in the Office of the Clerk of the County of Suffolk, in the State of New York, against the premises described herein and premises adjacent thereto on all sides from 2/9/1931 to date to ascertain the fee chain of title respecting said premises described herein and the premises abutting since 5/27/1948 and has found only the returns as set forth herein on the following pages as they bear on record title and; DOES certify that"the owners of the premises described herein have owned the same in single & separate ownership as defined by law during this period of time, except as otherwise shown herein". THIS Company's liability is limited to One Thousand(1,000.00) dollars for negligence only. No policy of insurance is to be issued hereunder. Tradition Title Agency, Inc. Agent for First American TitleInsurance Company of New York 1 /l t 41 Jo .h Intravaia ice President Title No. TRAD SS-19 Dated: 10/05/2007 • • SINGLE AND SEPARATE SEARCH SUBJECT PREMISES, District 1000 Section 142.00 Block 01.00 Lot 003.002: Joel S. Williams and Ada B. Williams Dated: 02/09/1931 To Rec'd: 08/19/1936 Ada B. Williams Liber 1878 Cp 266 Nathaniel W. Williams as executor of the last will and testament of Ada Wirth Williams Dated: 10/30/1973 To Rec'd: 11/05/1973 Charles R. Coutts, Jr. Liber 7524 Cp 11 Frances Coutts as sole heir-at-law of Charles R. Coutts, Jr. Dated: 07/27/2006 To Rec'd: 11/16/2006 Geoffrey R. Hallenbeck, III as Trustee of the Liber 12478 Cp 941 Frances J. Coutts Family Trust LAST DEED OF RECORD Or aArd-A-A— JoOrIntravaia • resident Dated: 10/05/2007 • • SUBJECT PREMISES, District 1000 Section 142.00 Blo 01.00 Lot 003.003:___ Sadie E. Ferris Dated: 05/03/1940 To Rec'd: 05/03/1940 Charles R. Coutts, Jr. and Frances Coutts, his wife Liber 2098 Cp 28 Frances Coutts individually and as Surviving tenant by the entirety Dated: 07/27/2006 To Rec'd: 11/16/2006 Geoffrey R. Hallenbeck, III as Trustee of the Liber 12478 Cp 939 Frances J. Coutts Family Trust LAST DEED OF RECORD 1' Jost Intravaia • • President Dated: 10/05/2007 • • Premises Adjacent Easterly: District 1000 Section 142.00 Block 01.00 Lot 002.000: Oliver R. Horton Dated: 05/27/1948 To Rec'd: 05/28/1948 Charles O. Bergen and Bertha R. Bergen Liber 2831 Cp 262 Bertha R. Bergen as surviving tenant by the entirety Dated: 08/09/1983 To Rec'd: 08/22/1983 Robert Marchica and Rhoda Dickerson Liber 9410 Cp 243 Robert Marchica and Rhoda Dickerson Dated: 01/02/1992 To Rec'd: 01/23/1992 Rhoda Marchica and Robert Marchica Liber 11406 Cp 57 LAST DEED OF RECORD 4041L Jose int ntravaia ice President Dated: 10/05/2007 • • Premises adjacent Southerly: District 1000 Section 142.00 Block 01.00 Lot 004.000; Joel S. Williams and Ada B. Williams Dated: 07/02/1924 To Rec'd: 11/19/1924 Stanley G. Davis and Agnes Davis Liber 1118 Cp 068 Patricia A. Yarusso a/k/a Letitia Yarrusso and Stanley Gordon Davis as heirs at law and Distributees of Agnes Davis Dated: 07/05/1967 To Rec'd: 07/12/1967 Letitia Yarrusso Liber 6183 Cp 324 Letitia Yarrusso Dated: 08/20/1993 To Rec'd: 08/31/1993 Robert H. Krudop Liber 11642 Cp 203 Robert H. Krudop Dated: 02/09/2004 To Rec'd: 02/27/2004 Steven Racanelli and Janine A. Racanelli Liber 12303 Cp 818 LAST DEED OF RECORD Aglp., (61.7714A-- os trIntrayaia Vice President Dated: 10/05/2007 . • • Premises Adjacent Easterly: District 1000 Section 142.00 Block 01.00 Lot 016.001; Joel S. Williams and Ada B. Williams Dated: 02/09/1931 To Rec'd: 08/19/1936 Ada B. Williams Liber 1898 Cp 266 CT r Nathaniel W. Williams, as devisee under the last will and testament of Ada B. Williams a/k/a Ada Wirth Williams Dated: 05/06/1976 To Rec'd: 05/19/1976 Fred Helf and Doris Helf Liber 8035 Cp 398 Fred Helf and Doris Helf Dated: 01/27/1977 To Rec'd: 02/18/1977 Tahir Can Deniz Liber 8193 Cp 413 Tahir Can Deniz Dated: 07/26/1984 To Rec'd: 08/08/1984 George J. Glogg and Alice D. Glogg Liber 9617 Cp 137 George J. Glogg and Alice D. Glogg Dated: 10/18/2000 To Rec'd: 07/19/2001 Jennifer Lee Liber 12130 Cp 772 • LAST DEED OF RECORD t/ / 4.4114 Ctuza-A— Josntravaia ice President Dated: 10/05/2007 , •, • • Premises Adjacent Easterly: District 1000 Section 142.00 Block 01.00 Lot 016.002; Joel S. Williams and Ada B. Williams Dated: 02/09/1931 To Rec'd: 08/19/1936 Ada B. Williams Liber 1898 Cp 266 Nathaniel W. Williams, as devisee under the last will and testament of Ada B. Williams a/k/a Ada Wirth Williams Dated: 05/06/1976 To Rec'd: 05/19/1976 Fred Helf Liber 8035 Cp 400 Doris Helf as executrix of Frederick Helf a/k/a Fred Helf Helf Dated: 11/24/1981 To Rec'd: 12/29/1981 Theodore Andruski Liber 9181 Cp 101 Theodore Andruski Dated: 08/05/1983 To Rec'd: 09/29/1983 Theodore Andruski and Marta L. Andruski Liber 9431 Cp 001 Theodore Andruski and Marta L. Andruski Dated: 04/28/1987 To Rec'd: 05/19/1987 Walter L. Dohm, Jr. and Kinta M. Dohm Liber 10322 Cp 529 / LAST DEED OF RECORD � i ��* L4 Ck Jo f a'* Intravaia •ice President Dated: 10/05/2007 • • Premises Adjacent Northerly: SOUND AVENUE // Jos' ,itntravaia Vice 'resident Dated: 10/05/2007 • • Premises Adjacent Westerly: FACTORY AVENUE re, 0.4: anii„ J. ntravaia President Dated: 10/05/2007 • • T- ...el 6 rV 1 1111111111111111111111111111111111111111 1101111111111111111 SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEEDS/DDD Recorded: 11/16/2006 Number of Pages: 3 At: 02:05:27 PM Receipt Number : 06-0111018 TRANSFER TAX NUNS$$; 06-13,134 LIBZR: D00012478 PAGE: 939 District: Section: Block: Lot: 1000 142.00 01.00 003.003 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $0.00 Received the Following Fees For Above Instrument Exempt Exempt e Pairs/Tiling $9.00 NO Handling $5.00 NO $5.00 NO NYS SRCHG $15.00 NO EA-CTY $5.00 NO EA-STATE $75.00 NO TP-584 $5.00 NO Cert.Copies $0.00 NO RPT $30.00 NO SCTM $0.00 NO Transfer tax $0.00 NO Comm.Pres $0.00 NO Fees Paid $149.00 TRANSFER TAX NUMBER: 06-13134 -. THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL Judith A. Pascale ` County Clerk, Suffolk County e k.. a '� , • 1 2 RECORDED r ambeiof Pag ea 2006 Nov 16 02:05:27 PM Judith P. Pascale CLEK OFSUFFOLK COUNTY erial# L D00012478 P939 ertificate# DT# 06-13134 Prior Ct£# Deed.Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 31 FEES Page/Riling Fee Mortgage Amt _ 1.Basic Tax Handling 5 .1:10_ 2.Additional Tax _ TP_584 5 - Sub Sub Total Spec./Assit. Notation — _ or EA-5217(County) - S Sub Tocol & Spee./Add. — r''� TOT.MTG TAX _ EA-5217(State) / Dual Town_ Dual County R.P.T.S.A. — :' Held for Appointment_ —. Transfer Tax �_ ,T.,‘,.:-.,,,,-,c'''' )3a- ' 5. is:: h Mansion Tax Z it t',.;.'5, ,XC ; - The property covered by this motgage is .3r s L'. •.2 or will be improved by a one orlwo family dwelling only. . ' Reg.Copy - Sub Total t H YES _ NO,see appropriais NOte tax clause on Other i Grand Total page# of this instrument. mict b -1— 21 Ol014M4 isSionBlocLot r� I 1 k.00 .....3.3 Community Preservation Fund x.:j 106029836 1000 14200 0100 003003 Consideration Amount $ -0- r i 'it p T s. CPP Tax Due $ -0- . Ttot Env-td Rp�K A / AgeEey 1 U (JImproved VerrBr�.aaa ... t, �•,' Vacant Lard 6 Satlsfattion/Discharges/Release List Property Owners Mailing Address TD a J RECORD&RETURN TO: DAVIDOW DAVIDOW SIEGEL&STERN LLP TD One Suffolk Square-Suite 330 1601 Veterans Memorial Highway TD Islandia,New York 11749 7 Title Company Information Co.Name Tide# '"t " ' ik County Recording & Endorsement Page This page forma part of the attached . Bargain and Sale DeJd rnade by: (SPECIFY TYPE OF INSTRUMENT) • FRANCES COUTTS by GEOFFREY R. HALLENBECK III as A*M-^^y in Fa-i- The premisis herein is situated in SUFFOLK COUNTY,NEW YORK. TO In the Township of Southold GEOFFREY E. HALLER BECK, III as Trustee of the FRANCES J. COLITIS FAMILY TRUST _ In the VILLAGE dated July 27. 2006. Matt/tuck or HAMLET of BOXES 6 THROUGH 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING �`' ' (over) • • Dear Taxpayers, Your satisfaction of mortgage has been filed in my office and I am enclosing the original copy for your records. If a portion of your monthly mortgage payment included your property taxes you will now need to contact vow local Town Tax Receiver so that you may be billed directly for all future oronerty tax bills Local property taxes are payable twice a year:on or before January 101h and on or before May 31'. Failure to make payments in a timely fashion could result in a penalty. Please contact your local Town Tax Receiver with any questions regarding tax payments. Babylon Town Receiver of Taxes Riverhead Town Receiver of Taxes 200 East Sunrise Highway 200 Howell Avenue North Lindenhurst,NY 11757 Riverhead,NY 11901 (631)957-3004 (631)727-3200 Brookhaven Town Receiver of Taxes Shelter Island Town Receiver of Taxes 250 East Main Street Shelter Island Town Hall Port Jefferson,NY 11777 Shelter Island,NY 11964 (631)473-0236 (631)749-3338 East Hampton Town Receiver of Taxes Smithtown Town Receiver of Taxes 300 Pantigo Place 99 West Main Street. East Hampton,NY 11937 Smithtown,NY 11787 (631)324-2770 (631)360-7610 Huntington Town Receiver of Taxes Southampton Town Receiver of Taxes 100 Main Street 116 Hampton Road Huntington,NY 11743 Southampton,NY 11968 (631)351-3217 (631)283-6514 blip Town Receiver of Taxes Southold Town Receiver of Taxes 40 Nassau Avenue 53095 Main Road Islip,NY 11751 Southold,NY 11971 (631)224.5580 (631)765-1803 Sincerely, Edward P.Romaine Suffolk County Clerk • NY 005-Bargain end Sok Deed with Covenant signet Gnnior's Area Individual or Capvadon(Single Shed)(NYBTU NW2) CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-TIES INSTRUMENT SHOW)BE USED BY LAWYERS ONLY • THIS INDENTURE,made the a1 day of ,in the year 2006 BETWEEN FRANCES COUNTS, individually and as surviving tenant by the entirety, by Geoffrey R. Hallenbeck, III, as Attorney-in-Fact, residing at 1570 Factory Avenue, Mattituck, New York 11952 party of the first part,and GEOFFREY R. HALLENBECK, III, residing at 2700 Camp Mineola Road, Mattituck, New York 11952, as Trustee of the FRANCES J. COUTTS FAMILY TRUST dated the 4e 7 day of July, 2006, party of the second pad, WITNESSETH,that the party of the first pan,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 past,the heirs or successors and assigns of the party of the second part forever, that tract or parcel of land with buildings and improvements thereon situate at Mattituck, Town of Southold, County of Suffolk and State of New York bounded as follows: On the West by Factory Avenue; on the South by land of Stanley D. Davis; on the East by land now or formerly of Joel S. Williams and on the North partly by land now or formerly of Charles S. Howell and partly by land now or formerly of Joel S. Williams. • SAID premises being known as 1570 Factory Avenue, Mattituck, New York 11952. • BEING AND INTENDED TO BE THE same premises conveyed to the party of the first • part by deed dated May 3, 1940, recorded in Liber 2098 page 28 in the office of the Clerk of the County of Suffolk. TOGETHER with all right title and interest,if any,of the party of the rust part of,in and to any streets and roads abutting the above-described premises to the centerlines 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 pan,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 incumbered 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 fust part has dulyggeesnted this deed ay and ear t /, 1 IN PRESENCE OF: geliegjeda �R�i!1 � Frances Gout6-_ p by Ueo trey R. Halienbeck,I] As Attorney— Fact • USEACKNOatEDOMmT FORM BELOW WIIBINNEWYORRS'ATEONLY: USE ACZNOWLEDGMENTFORM BELOW WR'WNNEW YORESTATE ONLY:. StateatNew York Countyof Suffolk )ss.: Stated'New York County of 1stt On than day of July in the year 2006 On the day of "in the year before me,the undersigned,personally appear c rances Coutts, before me,the undersigned,personally appeared by Geoffrey R. Itallesabeckk III, As Atte—in-Fact • personal Known to me or proved"So me on baso aaory personally known to Inc or proved to me on the basis of satisfactory evidence to be.the individual(s)whose name(s)is(are)subscribed to the evidence to be the individual(s)whose names)is(are)subscribed to the within insnumenuand acknowledged to me that he/she/they executed within instrument and acknowledged to me that helsheAhey executed the same in his/her/their capacity(id),.and that by his/her/their the same in his/her/rheir apacity(ies), and that by his/her/their signature(s)on the instrument,the individual(s),or the person upon signature(s)on the instrument,the individual(s),or the person upon �beha�lf of which the individ executed the instrument behalf of which the individual(s)acted,executed the insoument Notary 0 NSKY • MtlfE CK thlMn Stateat NeW till Ndary Nrdi I EDI UNM mannaerosion E �uAug 1C C�� ACKNOWLEDGMENT FORM FOR USE WITHIN NEW YORK STATE ONLY: ACKNOWLEDGMENT FORM FOR USE OUTSIDE NEW YORE'STATE ONLY: (New York Subscribing Witness Acknowledgment Cenifkote/ (Out ofState or Foreign General Acknowledgment CsnificateI State ofNew York Countyof )ss.: 1 sa: (Campkie Venue with State.Cmwry.Province or Municipality) On the day of in the year before me,the undersigned,personally appeared On the day of in the year before me,the undersigned,personally appeared the subscribing witness to the foregoing instrument,with whom I am • personally acquainted,who,being by me duly sworn,did depose and personally known to me or proved to me on the basis of satisfactory say that he/she/they reside(s)in evidence to be the individual(s)whose name(s)is(are)subscribed to the within instrument and acknowledged to me that hdshdhey executed (iithe place of residence is in a city,include the street andstreet number, the same in his/her/their capacity(ies),that by hishted their signature(s) if any,thereof);that he/she/they know(s) on the instrument,the individual(s),or the person upon behalf ofwhich the individuals)acted,executed the instrument,and that such individual to be the individual described in and who executed the foregoing made such appearance before the undersigned in the instrument;that said subscribing witness was present and saw said execute the same;and that said witness at the same time subscribed (Insert the city or other political subdivision and the sale or country or his/her/their name(s)as a witness thereto. other place the acbwwledgment was taken). BARGAIN&SALE DEED W RN COVENANTS AGAINST O V.MCR'S ACR TITLE NO. DISTRICT SECTION Frances Coutts, by Geoffrey R. BLOCK Hallenbeck, III, As Attorney—in—Fact LOT COUNTY OR TOWN TO Geoffrey Y. Hallenbeck, III, As RECORDED AT REQUEST OF Trustee of the FRANCES J. Fidelity National Title Insurance Company ofNew York MILT TRUST dated 7/ /06 RETURN BYMNLTO FIDELITY NATIONAL TITLE INSURANCE Davidow Davidow Siegel and Stern,LLP COMPANY OF NEW YORK One Suffolk Square-Suite 330 1NCtl"O"n'm 191111601 Veterans Memorial Highway Islandia,New York 11749 c cur a:Fidelity 2,#,....," Mende New e.wSiam unhA,...Mm. may W i a a g 8 W 6 W5 N Qpo LL 6 pc N g W i 6 I 6 uot?freitittOggiVit DrFi r.0 Gwent withLle C,.nt ,.. ...„.....:,.....,,,.....,.,,.._. Claws at ant, asp.M. Matter) s A.Obp.827 law.of 1e2) We law AlntPubbsh.rsBW/end,R. A • y 10 tt �ltltir�, Made the 3 '� day of May Nineteen Hundred and Forty ya�,.. ` •�� \ ¶3 i9tJJVrtn SADIE' E. FERRIS, residing at 66 Althouse Avenue, • East Rockaway, Hew York, • party of the first part,and CHARLES R. COUTTS, JR. and FRANCES CODTTS, his wife, residing at Idattituck, Suffolk County, New York, part ies of the second part, CeritntAkit4p that the part y of the first part, in consideration of One Dollar ($ 1.00 ) lawful) money of the United States, and other good and valuable consideration paid by the parties of ape second part, do es hereby grant and release unto the part ies of the second part, their heirs and assigns forever, all that tract or parcel of land tith buildings ana invf,rovements thereon situate at Dattit}.ck Town pt i. z^.” Davis; on.the Ass ,''ripan• •now •r formerly`Ot Joel 3' 'W112iaffia aad I on the North partly,brlland now or formerly of Charles S. Howell and partly by land now or formerly of Joel S. Williams. BEING AND INTENDED TO BE the same premises conveyed by Joel S rir a•-. v‘4-1 n , • • II ', • ;;,,77�� i�R_2 098 PAGE 29 t'ries tt with the appurtenances and all the estate and rights of the pa�rtty of the first 4p�art inandto said premises, ��(t tt intik to hole the premises herein granted unto the part ies of the second part, their,heirs and assigns forever. • • said Sadie E. Ferris covenant s as follows: t. That said Sadie E. Ferris is seized of said premises in fee simple, and has good right to convey the same; *As. That the part ies of the second part shall quietly enjoy the said premises, atilt; That the said premises are free from incumbrances; 3tautl[. That the part y of the first part will execute or procure any further necessary assurance of the title to said premises; e +�• That said Sadie E. Ferris will forever (1Utrrnnt the title to said premises. SiXth. That the grantor receive the consideration for this conveyance as a trust fund to be applied first for the purpose of paying the cost of any improvement, that has been commenced pcpon the premises and has not beencompleted at least four months before the making and recording of this deed, and that the grantor will apply the sante first to the payment of the cost of improvement before using any part of the total of the same for any other purposes. r�n kl #,Ceha 4, the party of the first part ha s hereunto set77Iher hand and seal the day and year first above written. ,: ttJJresntre of jL ° g 0 .tu..& s I $ill iJ uhl$ill L $,➢I f, ' �EF O 8 °AGE �U. U • State of Nr1tt f or dt • C7ouutg of Suffolk sg^ of On Chia "—e." day of:day Nineteen Hundred and Forty before me, the subscriber, personally appeared SADIE E. FERRIS to me personally known and known to me to be the same person described in and who executed the within Instrument, ands he duly acknowledged to me that she executed same {7', lei: f / (l/ Gf r c G�Gr ccs[, Notary Public, Suffolk County MAY 3 j F i3 . 2192 PNkf('IARKlAR Clerk of Sntfolk County • 0 n J o- L. : . J O -.L y .. w OY y2 ¢ \ t f ao to 0 f ® OU W Q N -U tit U Z w F m W Q gV F O H i rd .,, CO, 3 a a W °�n, .` IA —5 1.+ P: � k) W ro / � "� �. ` o IC) ° I ' ..‘g � \ iq Standard N.Y.B.T.tJ. Form Boos B .aeeurors Deed—Indlv,dp.l or Corporar'r+,Isws1e .I LIBER (0C4 PACE 1.1 CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTS—THIS INSTRUMENT SHOULD BE USED BY LAWY Y. �� THIS INDENTURE,nude the 2 C5 day of C)Cs" s ,nineteen hundred and seventy three • BETWEEN NATHANIEL W. WILLIAMS ' ,ll fL£sulKG Ff •Ftcton--e Aot ma as executor of ADA WIRTH WILLIAMS the last will and testament of Factory Avenue, Mattituck, New York ,late of ,deceased, party of the first part,abd CHARLES R. COUTTS, JR. (rSsatrvS hr Mat,:t re.° /14,P,—r7,ruc{c 'gest "Lit party of the second part, — � 5 WITNESSETH,that the party of the first part,by virtue of the power and authority given in and by said last `^'/`, will and testament,and in consideration of ' FOUR THOUSAND ($4,000.00) dollars, 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, �O I C�) ALL that certain plot,piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being roe at Mattituck, Town of Southold, County of Suffolk and State of New York; bounded and described as follows: w BEGINNING at the intersection of the corner formed by the 0 ~ * Southerly side of Sound Avenue and the Easterly side of Factory a Avenue, running thence South 100 feet mor or less to land of the purchaser; us ¢ t4UNNiNG THENCE along said land East 100 feet more or less to land of Bergen; RUNNING WAAMUt ;along said land North 100 feet more or less to the' Southerly sidelor Sound Avenue; RUNNING THENCE along the Southerly side of Sound Avenue West 100 feet more or less to the point or place of BEGINNING. SUBJECT to any state of facts an accurate survey may show. TOGETHER with all right,title and interest,if any,of the party of the first part of,in and to any streets and roads abutting the above-described premises to the center lines thereof;TOGETHER with the appurtenances, and also all the estate which the bald decedent had at the time of decedent's death in said premises,and also the estate therein,whichthe patty of the first part has or has power to convey or dispose of,whether individ- ually,'or by virtue of said will or otherwise; 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 incumbered 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 consid- eration 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 "partici' 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: �J.11 ;10 * t �f ryVi �APirsvrncJ TitA15FE8�TAXy NEU[U0 K ecutor of the Estate of - to' bep(:pt +e°' x Ada Wirth Williams, Deceased. °oy IGl(Bilga aBl E,3'- - . zu'c 't �, �,f1BOnfB `P.B I0585 il(:. .. _1 UBE?7524a 12 rSTATE OF NEW YO COUNTY OF SUFFOLK SS: STATE OF NE ORK,COUNTY OF 55, On the ,:it,A day of October 1973,before me On the day of 19 ,before me personally came personally came NATHANIEL W. WILLIAMS . • to me known to be the individual described in and who to me known to be the individual described in and who executed the foregoing instrument, and acknowledged that executed the foregoing instrument, and acknowledged that he executed the same.O. C executed the same. O. Com,_.(�.....�1!/.C.' OB pf/ WILUAM CCARR NOTARY MUG,Ham a Now You • No.626712604 Qnai7 'L Term Nosh 4. STATE OF NEW YORK, COUNTY OF S5: STATE OF NEW YORK,COUNTY OF 55: On the day of 19 ,before me On the day of 19 ,before me personally came a •,• ,•, personally Came to me known, who,being by me duly sworn, did.depose and the subscribing witness to the foregoing instrument, with say that he resides at No. whom I am personally acquainted, who, being by me duly • - ="'t , sworn,did depose and say that he resides at No. that he is the of that he knows , the corporation described in and which executed the foregoing instrument; that he to be the individual knows the seal of said corporation; that the seal affixed described in and who executed the foregoing instrument; to said instrument is such corporate seal; that it was so that he, said subscribing witness, was present and saw O affixed by order of the board of directors of said corpora- execute the same;and that he,said witness, O tion, and that he signed h name thereto by like order. at the same time subscribed h name as witness thereto. 1- Z Q I, I • a Z C W J ___ . . _."... V _.. I,. } I- 7 u f11 of t�uo Ul, � T m m E c z U cid m 0 n , 04, W e- w m ea •e o W NI lt lt H c-, A O 0.1 W f. O' o z o e' Rd v -x o WO m a m o a Record and Return To: O f.. y e.5 a F . u ' Willi am J. Clark, Esq. U K . — Middle Road o p Mattituck, New York 11952 C V e, A •C 9 F in e H U Z O -.-y p O r To, Y CC r..:- tat r- O o e'_ a o ,.--,'-t . - Ui . yr :r r N" . w ~ o yll r gyp -vw Standard N.Y.B.T.U.Form 6005 8. 'Lxecumi s Deed—Individual or Corporanw,(single 0 LIBER 7524 FACE 11 CONSULT YOUR LAWYER BEFORE SIGNING THIS INS —THIS INSTRUMENT SHOULD BE USED BY LAWNLY. i ITHIS INDENTURE,made the '1 day of DC/ c ,nineteen hundred and seventy three BETWEEN NATHANIEL W. WILLIAMS 2£snf,..' iC `P,c.xo,c-, not NSntzTLruc(C as executor of ADA WIRTH WILLIAMS the last will and testament of Factory Avenue, Mattituck, New York ,late of ,deceased, party of the first part, and CHARLES B. COUTTS, JR. R-£solmb Ant Mesut.res) yln.A-D 7t r Sack t-rei party of the second part, — WITNESSETH,that the party of the first part,by virtue of the power and authority given in and by said last will and testament,and in consideration of FOUR THOUSAND ($4,000.00) dollars, 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, �Q ICl ALL that certain plot,piece or parcel of land, with the buildings and improvements thereon erected, situate, T'i • lying and being SEM at Mattituck, Town of Southold, County of Suffolk and State of New York, bounded and described as follows: BEGINNING at the intersection of the corner formed by the V' eeSoutherly side of Sound Avenue and the Easterly side of Factory Avenue, running thence South 100 feet mor or less to land of the '4, purchaser; uco . cc RUNNING THENCE along said land East 100 feet more or less to land of Bergen; RUNNING THENCE along said land North 100 feet more or less to the' Southerly aideiof Sound Avenue; RUNNING THENCE along the Southerly side of Sound Avenue West 100 feet more or less to the point or place of BEGINNING. SUBJECT to any state of facts an accurate survey may show. TOGETHER with all right,title and interest,if any,of the party of the first part of,in and to any streets and roads abutting the above-described premises to the center lines thereof;TOGETHER with the appurtenances, and also all the estate which the Said decedent had at the time of decedent's death in said premises,and also the estate therein,whichthe party of the first part has or has power to convey or dispose of,whether individ- ually,or by virtue of said will or otherwise;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 incumbered 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 consid- eration 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: fiRAtI pER;TAX Nf O KESEeccutor of the Estate of h`` gH Depr.ul 4 Y Ada Wirth Williams, Deceased. M laxatiAn rise Sia z ��4! Y A: ' ' �BER 7524E 12 • STATE OF NEW YORK, COUNTY OF SAFFOIiK SS: STATE OF NEW YORK,COUNTY OF SS: On the JO# day of October 1973,before me On the day of 19 ,before me personally came personally came NATHANIEL W. WILMM to me known to be the individual described in and who to me known to be the individual described in and who executed the foregoing instrument, and acknowledged that executed the foregoing instrument, and acknowledged that he executed the same. executed the same. Atialg YRLUAM MARK NOTARY IUSUc,Stale of New Yu! No. S3-f7t$N Ursa Expires is Suffolk Counts Ursa Expires Marsh 30, 197X STATE OF NEW YORK, COUNTY OF SS: STATE OF NEW YORK,COUNTY OF SS: On the day of 19 ,before me On the day of 19 ,before me personally came a personally came to me known, who, being by me duly sworn,did depose and the subscribing witness to the foregoing instrument, with say that he resides at No. whom I am personally acquainted, who, being by me duly • 'ti , sworn,did depose and say that he resides at No. that he is the , of that he knows ,the corporation described in and which executed the foregoing instrument; that he to be the individual knows the seal of said corporation; that the seal affixed described in and who executed the foregoing instrument; to said instrument is such corporate seal; that it was so that he, said subscribing witness, was present and saw 8. affixed by order of the board of directors of said corpora- execute the same;and that he,said witness, tion, and that he signed h name thereto by like order. at the same time subscribed h name as witness thereto. s- I- Z C C LI l7 O z C w J F- N rcl 10' V tu UN: D 01 E c 011 N Z U O E'1 c r-I rr fs7 .d' 3 o o PP N Q. 0 .i.Re w H rb St LLI O T p c' « O M Al • O 4 - 0 at M a o-a Record and Return To: /�� F. L F. T i H J • W S. u to u Willi am J. Clark, Esq. UK Middle Road VO 4 .2 0.`o a Mattituck, New York 11952 .. t El L -0 F u .. U • o _. u z_ oaa' x p m r U CC., oen , W W in �` r p O •_ LVF--, Q O �i < w N a o r .wrruu V [ '�i6 SOUTHOLO sEcnYNxo - _,. --.-- — -- -- a;ab:m � Red Property lax Sa'vice Agency r .. — ,,.,�Y yr,. �N --— .. . — -- `_" __ —.,-- " .t. MOOT!MURK( IA a y '=, CenterRenege Y nen ; a 141 ,.www v..ww.w . ". , w .�« a wea.w a u. n-- aw atria mi..Klim61R YN— sn - �/y� /1 \/rn�/ (l/ l/u fFc.m[r. ��yj Jr1 r P r6R110 MO /1 T�.LFA I R I/ f DIY / I 7� �/ -V /P -. PROPERTY NM ig. /Co / 41 3" 4. 3 46-` Wly� �.�� �L I I3 �2--- OO s % 411‘ . t 9y �Y • <pNlit. L F v/ 6 t. YY .- • yr/ • /tl /$ qSy / • b P / - -- NOTICE vi, COUNTY OF SUFFOLK Q K 'o' SOUTOOLO SECTION NO w — izv ,,.. ., .a --.-- .....:r" ,."` OM Trot., .rr—.., ,a,.�.OF �f 2 Red Property tax Service Agcy r ��_ 010,110.•OF POI6IYI .,.R, 142 .,.. —23 _ -- ,_ —_- — -- - .cwm,.,..,,.ate q Noon[ni ae.ragxr • uee Yin ••• —. -- ri..un___ nitrous .n mw, e�o>K �C 1ti� 9 lune`Ni P mlmw titi��thi A.ia.r un mom. vwnrr —-t _ •e.°.wxn�w . ua , •1.1- •" P 1000 PROPERTY YM . t /I ,. aV'\ L- .; .t Lawrence Eric Daviduw !II ti 7 + Lawrence A.S.agel II�� ""�^^+��� Harry A.Davidow E Steven H.Stam° (1890-1954) f Michelle J.ibloitsky DAVIDOW DAA Reek r OW, SIEGEL & STERN LLP Walla=F.Davidow Regina E VlucKay Sanford I—Davi dins I Martin S Glnss Cormss elo at Law•OripiralFFrnrFounded 1913 11 Oiled Ben-A-ni Nassau ce• j; One Suffolk Square•Suite 330•1601 Veterans Memorial Highway•Islandia,New York 11749 666 OldOffiCountry Road 1 vcl Tel(631)234-3030•Fax(631)234.3140 Suite8ln GinOfCanruRnio Shrum Anne-blanc Monahan Website: www.davidowlaw.com Garden Ctry,NY 11530 11 Robert E.Pipia Tel(516)393.0222 I Fax(516)228-6672 l "Admitted to Honda Bar Ertst End Ofce• ill r 13165 Main Road PO Box 344 Mattituck,NY 11952 Via Facsimile 631-765-9064 Tel(631)299-9600 Fac(B1)761-0370 February 21, 2008 Town of Southold �� Southhold Town Zoning Board of Appeals II Town Hall Annex Building # 53095 Main Road PO Box 1179 Southold,New York 11971-0959 Re: Francis J. Coutts Family Trust by Geoffrey Hallenbeck III, Trustee#6098 Location of Property: 10650 Sound Avenue,Mattituck, New York Dear Sir or Madam: As per the Board's request, enclosed please find the following: { 1. Letter from Dr. Cynthia H. Ickes; and 2. Copy of notice from the Suffolk County Department of Social Services. I will be out of the office from February 25 through February 29,2008. Please feel free to contact me upon my return with any questions, Very truly yours, DAVIDOW,DAVIDO W,SIEGEL&STERN,LLP a 1 I Michelle lonsky 1 t t I i 1 1 I .1 ,,,,..........,.: z •d 0171E17E2 mouIt1du#moaIAdu wdi7s :a 13002 12 clad m 11 ii CDUTTS FRANCES ' �,p,,v , ,•.' Cynthia H. Ickes, M.D., P.C. '''' Y Nift q 222 Manor Place 631-477-2626 lrt 13 Fl�i Greenport,New York 11944 fax 631-477-2604 11 February 14,2008 11 Michelle Jablonsky, Esq 'l Davidow Davidow Seigel and Stem, `' - 1601 Veterans Memorial Hwy; Ste 330 Islandia,NY 11749 Fax: 6331-234-3140 Dear Ms. Jablonsky: , _ _ _ _ _ __.._ _ t ;i I have been seeing Frances Coutts for almost 10 years now for all medical issues. She sustained a hip fracture a number of years ago and was not able to return home alone. She has been living at San Simeon Center for Nursing and Rehabilitation for the past few • years but could return home if she had 24 hour home health aide support. I financial her nephew has been taking care of her and medical affairs and is attempting to liquidate some her assets in order to pay medical bills. He has asked me to send this information to you. We hope this information is of help to you. : `/ Sincer , Cynthi H.Ickes, /ci i t i i 0 I{{j rt E •d Ot'T EbE2 mon I Abu I'wn I ABa Wdi7S :2 8002 la QaJ t{ 71 l' . J f :I SUFFOLK COUNTY DSS NOTICE OF DECISION ON YOUR MEDICAID CHRONIC CARE UNIT 'MEDICAL ASSISTANCE. 3085 VETERANS MEMORIAL HIGHWAY RONEONEOMA, NY 11779 SI UISTED DESEA RECIBIR NOTIFICACIONES FUTURAS EN ISPANOL, POR FAVOR PONGASE EN CONTACT!) CON SU TRABa_7ADOR(A). NOTICE NUMBER: DATE: CASE NUMBER: U4711156530 November 16, 2006 H00A55837 OFFICE UNIT WORKER _ __ .. UNIT OR.WORKER NAME _. ____ .•••_- TELEPHONE NO. - -- 0 -- • OCC- - - "02658 S. HILL 631--854=9298 '•' •.. • - AGEN. Y TELEPHONE NUMBERS CASE NAME/AND ADDRESS GENERAL TELEPHONE NO. 631-854-9555 ' FOR QUESTIONS E OR HELP OR Agency Conference 631-854-9555 . 0/OCC/D265E I Fair Hearing 1,��11,��111�6�J.�LI�J���lll information and 800-342-3334 assistance COUTTS FRANCES ' `SAN SIMNEON NB 61700 RT 48 GREENPORT, NY 1194.4 ' Record Access 631-854-9555 1 Child/Teen Health Plan 631-859-9597 IF YOU DO NOT AGREE WITH ANY DECISION EXPLAINED IN THIS NOTICE, YOU HAVE A RIGHT TO ASK US FOR A CONFERENCE AND/OR ASK THE STATE FOR A FAIR HEARING. READ THE CONFERENCE AND/OR FAIR HEARING SECTION TO SEE HOW TO ASK FOR A CONFERENCE AND/OR A FAIR HEARING. 1 MEDIC ) ASSISTANCE i We have denied your application for Medical Assistance dated September 29, 2006 # for: Name Client I.D. t FRANCES J. COUTTS EAIS677D This is because your countable resources of $163,901.19 are over the allowable Medical Assistance resource limit of $4,150.00. The amount over the limit is called excess resources or spenddown. Your excess resource amount is $159,751.19. Also, we have not received documentation that you have spent your excess resources 1 by establishing or adding to a burial trust/fund. Please look at the budget calculation section to see how we figured your excess • 1 resources. If you incur, medical bills in the amount of your excess resources or if the amount fof your resources goes down, you may reapply. i Please read the "Explanation of the Excess Resources Program" Section. 1 This decision is based on Regulation 18 NYCRR 360-4.8. Ii \ 1 \ t+ 'd Ot71EtrC2 r10QIhkiaitnouiAda Wdt,E :2 8002 'Ea gad ea IDS' Housing Assistance Payments Contract u.s. Department of Housing OMB Approval No,2577-0169 and Urban Development (exp.07/31/2007) (HAP Contract) Office of Public and Indian Housing Section 8 Tenant-Based Assistance Housing Choice Voucher Program Tenant ID V190A Part A of the HAP Contract: Contract Information (To prepare the contract,fill out all contract information in Part A.) 1. Contents of Contract This I-IAP contract has three parts: Part A:Contract Information • Part B:Body of Contract Part C:Tenancy Addendum 2. Tenant Barbara J.Sailor 3. Contract Unit '1570 Factory Avenue Mattituck, NY 11952 4. Household The following persons may reside in the unit. Other persons may not be added to the household without prior written approval of the owner and the PHA. Brian Husfeldt • 5. Initial Lease Term The initial lease term begins on(mm/dd/yyyy): 08101/2007 The initial lease term ends on(mm/dd/yyyy): 07/31/2008 6. Initial Rent to Owner The initial rent to owner is:$ 1,025.00 . During the initial lease term,the owner may not raise the rent to owner. 7, Initial Housing Assistance Payment The HAP contract terns conunences on the first day of the initial lease term. At the beginning of the HAP contract team,the amount of the housing assistance payment by the PI-IA to the owner is$ 672.00 per month. The amount of the monthly housing assistance payment by the PHA to the owner is subject to change during the HAP contract term in accordance with HUD requirements. •Previous editions.are obsolete Page 1 of 2 form HUD-62641 (1/2007) HAPPY Software ref Handbook 7420.8 1 (.I • • 8, Utilities and Appliances ' The owner shall provide or pay foi the utilities and appliances indicated below by an"011. The tenant shall provide or pay for the utilities and appliances ' indicated below by a"T11. Unless otherwise specified below,the owner shall pay for all utilities and appliances provided by the owner. ' Item Specify Fuel Type Provided By Paid By Heating ®Natural Gas ❑Bottle Gas ❑Oil ❑Electric ❑Coal ❑Other T T Cooking ®Natural Gas ❑Bottle Gas ❑Oil ❑Electric ' ❑Coal ❑Other T T Water Heating ❑Natural Gas ❑Bottle Gas ❑Oil ®Electric ❑Coal ❑Other T T ;;:•,;•:.. ,:,::;,;,...:.,,•;.;:.:.;:,,:.:::.•:.::•:;:::;;::,::':; T T Other Electrl .•,• : ' . ,•.••.•....::...:..:.::. .:•:'::::::;:•, • Wt aor ... .. 0 Sewer • '•• • "• Trash Collection - . . ••_ T T • • .. :. T T Air Conditioning 1""1'I"""';f 1"1M I;I'"','1�1.'•'.'V"'I'I"' "1,11'•'8'.il,'" Illi,111•,.;"I'lll,'l'1.11'111��I'III',III,I' .1!' '••1••I'••i l..li'I"I' 'i • Refrigerator :..; 0 ,1,11111181,•1..,.1,.,1111,'•11.111,',IL•.II „',Il,.i 1,111,11N„;„isllal,ill,,,il IIi11i1111,I1i.,l;,ll,i .:,!i„illi„!,Ill,!„1 •1.H.,,.11,1!11.•.i.ii,i„!'1.,,. Range/Microwave • • .. :` • ' O Other(specify) ' Sig atures: Pu c Housing Agency Owner Nor, •1. Fork Hou1•`II. lance Inc. Franc=- Coutts Family Trust . ill _ 11r P , Type N:me of 0 r � � 0 ;-1 /w” / / 7. 0:-.0: ?-6411 -17:" )6 . AW' di I Signature ,, nal/r.7 Tanya PtrI ore, Executive Director ec I l'tAfy . I/fry tecf< 471- Print or Type Name and Title of Signatory`7 rint r Type aNe and Title of Signatory g9.4 g/'zy 07 Date(nin/dd/yyyy) Date(mmldd/yyyy) - Mail Payments To: - Frances Coutts Family Trust Geoffrey R. Hallenbeck,Ill Name, 1570 Factory Avenue Address ' Mattituck, NY 11952 City,State,ZIP Previous editions are obsolete Page 2 of 2 form HUD-52641 (1/2007) HAPPY Software ref Handbook 7420.8 , Housing Assistance Payments Contract U.S. Department of Housing OMB Approval No.2577-0169 (HAP Contract) and Utban Development (exp.07/31/2007) Section 8 Tenant-Based Assistance Office of Public and Indian Housing . Housing Choice Voucher Program Part B of HAP Contract: Body of Contract for such breach include recovery of overpayments, suspension of housing assistance payments,abatement or other reduction of housing assistance payments, I. Purpose • termination of housing assistance payments, and a. This is a-HAP contract between the PHA and the termination of the HAP contract The PHA may not owner. The HAP contract is entered to provide exercise such remedies against the owner because of assistance for the family under the Section 8 voucher an HQS breach for which the family is responsible, program(see HUD program regulations at 24 Code of and that is not caused by the owner. Federal Regulations Part 982). d. The PHA shall not make any housing assistance b. The HAP contract only applies to the household and payments if the contract unit does not meet the HQS, contract unit specified in Part A of the HAP contract. unless the owner corrects the defect within the period c. ' During the I-1AP contract term, ,the PI-IA will pay specified by the PIIA and the PHA verifies the , housing assistance payments to the owner in correction. If a defect is life threatening, the owner accordance with the HAP contract. must correct the defect within no more than 24 hours. d. The family will reside in the contract unit with For other defects, the owner must correct the defect assistance under the Section 8 voucher program. The within the period specified by the PHA. e. The PHA may inspect the contract unit and premises housing assistance payments by the PHA assist the tenant to lease the contract unit from the owner for at such times as the PHA determines necessary, to occupancy by the family. ensure that the unit is in accordance with the HQS. f. The PHA must notify the owner of any HQS defects shown by the inspection. 2. Lease of Contract Unit g. The owner must provide all housing services as agreed a. The owner has leased the contract unit to the tenant to in the lease. for occupancy by the family with assistance under the Section 8 voucher program. 4. Term of HAP Contract b. The PHA has approved leasing of the unit in a. Relation to lease term.The term of the HAP contract accordance with requirements of the Section .8 begins on the first day of the initial term of the lease, voucher program. and terminates on the last day of the term of the lease c. The lease for the contract unit must include word-for- (including the initial lease term and any extensions). word all provisions of the tenancy addendum required b. When HAP contract terminates. by HUD(Part C of the HAP contract). d. The owner certifies that: (1) The HAP contract terminates automatically if (1) The owner and the tenant have entered into a lite lease is terminated by the owner or the lease of the contract unit that includes all tenant. provisions of the tenancy addendum. (2) The PHA may terminate program assistance for (2) The lease is in a standard form that is used in the the family for any grounds authorized in locality by the owner and that is generally used accordance with HUD requirements.If the PHA for other unassisted tenants in the premises. terminates program assistance for the family,the (3) The lease is consistent with State and local law. HAP contract terminates automatically. e. The owner is responsible fon screening the family's (3) If the family moves from the contract unit, the behavior or suitability for tenancy. The PHA is not HAP contract terminates automatically. responsible for such screening. The PIIA has no (4) The 1-lAP contract terminates automatically 180 liability on responsibility to the owner of other persons calendar days atter the last housing assistance for the family's behavior or the Ihmily's conduct in payment to the owner. tenancy. (5) The PHA may terminate the HAP contract if the PHA determines, in accordance with IND ' 3. Maintenance,Utilities,and Other Services requirements,that available program funding is a. The owner must maintain the contract unit and not sufficient to support continued assistance for premises in accordance with the housing quality • families in the program. i standards(HQS). { b. The owner must provide all utilities needed to comply with the HQS. c. If the owner does not maintain the contract unit in accordance with the HQS, or fails to provide all _ utilities needed to comply with the HQS,the PHA may exercise any available remedies. PHA remedies Previous editions are obsoleteform HUD-62641 (1/2007) Page 1 of 8 HAPPY Software ref Handbook 7420.8 . 1 (6) The PIIA may terminate the IIAP contract if the penalties for late payment by a tenant. I-Iowever, PHA determines that the contract unit does not the PHA shall not be obligated to pay any late provide adequate space in accordance with the payment penalty if HUD determines that late HQS because of an increase in family size or a • payment by the PHA is due to factors beyond the change in family composition. P1-IA's control. Moreover, the PHA shall not be (7) If the family breaks up, the PI-IA may terminate obligated to pay any late payment penally if the HAP contract, or may continue housing housing assistance payments by the PHA are assistance payments on behalf of Iiunily members delayed or denied as a!moody for owner breach of who remain in the contract unit. the HAP contract(including any of the following (8) The PHA may terminate the IIAP contract if the PIIA remedies: recovery of overpayments, PHA determines that the unit does not meet all suspension of housing assistance payments, requirements of the I-IQS,or determines that the abatement or reduction of housing assistance owner has otherwise breached the HAP contract. payments, termination of housing assistance payments and termination of the contract). 5. Provision and Payment for Utilities and Appliances (4) housing assistance payments shall only be paid to a. The lease must specify what utilities are to be provided the owner while the family is residing in the or paid by the owner or the tenant. contract unit during the term of the HAP contract. The PHA shall not pay a housing assistance b. The lease must specify what appliances are to be payment to the owner for any month after the provided or paid by the owner or the tenant. month when the family moves out. c, Part A of the I-IAP contract specifies what utilities and b. , Owner compliance with HAP contract. Unless the appliances are to be provided or paid by the owner or owner has complied with all provisions of the HAP the tenant. The lease shall be consistent with the HAP contract, the owner does not have a right to receive contract. housing assistance payments under the HAP contract. c. Amount of PHA payment to owner 6. Rent to Owner:Reasonable Rent (1) The amount of the monthly PHA housing a. During the HAP contract term,the rent to owner may assistance payment to the owner shall be • at no time exceed the reasonable rent for the contract determined by the PHA in accordance with HUD unit as most recently determined or redetermined by the ' requirements for a tenancy under the voucher PHA in accordance with HUD requirements, program. b. The PHA must determine whether the rent to owner is (2) The amount of the PHA housing assistance reasonable in comparison to rent for other comparable payment is subject to change during the HAP unassisted units To make this determination,the PIIA contract term in accordance with HUD must consider. requirements. The PHA must notify the family (1) The location, quality, size, unit type, and age of and the owner of any changes in the amount of the contract unit;and the housing assistance payment. • (2) Any amenities, housing services, maintenance (3) The housing assistance payment for the first and utilities provided and paid by the owner. month of the HAP contract term shall be prorated c. The PHA must redetermine the reasonable rent when for a partial month. required in accordance with HUD requirements. The d. Application of payment. The monthly housing PHA may redetermine the reasonable rent at any time assistance payment shall be credited against the monthly d. During the HAP contract term,the rent to owner may rent to owner for the contract unit not exceed rent charged by the owner for comparable e. Limit of PHA responsibility. unassisted units in the premises.The owner must give (1) The PHA is only responsible for making housing the PHA any information requested by the PHA on tents assistance payments to the owner in accordance charged by the owner for other units in the premises or with the HAP contract and HUD requirements for elsewhere. a tenancy under the voucher program. 7. PHA Payment to Owner owner The PHA shall not pay any portion of the rent to owner in excess of the housing assistance a. When paid payment. The PHA shall not pay any other claim (1) During the term of the HAP contract, the PHA by the owner against the family. must make monthly housing assistance payments f, Overpayment to owner.If the PHA determines that the to the owner on behalf of the family at the owner is not entitled to the housing assistance payment beginning of each month. or any part of it,the PHA,in addition to other remedies, (2) The PHA must pay housing assistance payments may deduct the amount of the overpayment from any promptly when due to the owner. amounts due the owner (including amounts due under (3) if housing assistance payments are not paid any other Section 8 assistance contract). promptly when due miner the first two calendar months of the HAP contract term, the PHA shall 8. Owner Certification pay the owner _penalties in accordance with During the term of this contract,the owner certifies that: generally accepted practices and law,as applicable a. The owner is maintaining the contract unit and premises in the local housing market, governing . in accordance with the HQS. Previous editions are obsoletePage 2 of 8 form HUD-62641 (1/2007) HAPPY Software ref Handbook 7420.8 • b. The contract unit is leased to the tenant, The lease b. If the PHA determines that a breach has occurred, the includes the tenancy addendum (Part C of the HAP PHA may exercise any of its rights and remedies under contract), and is in accordance with the HAP contract the HAP contract, or any other available rights and and program requirements.The owner has provided the remedies for such breach.The PIIA shall notify the owner lease to the PHA,including any revisions of the lease, of such determination,including a brief statement of the c. The tent to owner does not exceed rents charged by the reasons for the determination, The notice by the PHA to owner for rental of comparable unassisted units in the the owner may require the owner to take corrective action, premises. as verified or determined by the PHA, by a deadline d, Except for the rent to owner,the owner has not received prescribed in the notice. and will not receive any payments or other consideration c. The PHA's rights and remedies for owner breach of the (from the family,the PHA,HND,or any other public or HAP contract include recovery of overpayments, private source)for rental of the contract unit during the suspension of housing assistance payments,abatement or I-IAP contract termother reduction of housing assistance payments, e. The family does not own or have any interest in the termination of housing assistance payments, and contract unit. termination of the HAP contract. f. To the best of the owner's knowledge, the members of d. The PHA may seek and obtain additional relief by judicial the family reside in the contract unit,and the unit is the order or action? including specific performance, other family's only residence, injundtive relief or order for damages. g. The owner (including a principal or other interested party)is not theparent, grandparent, grandchild, . ' e. Even if the family continues to live in the contract unit, P y) child, g P ' g the PI-IA may exercise any tights and remedies for owner aisle!, or (mother of any member of the family, unless , the NIA has determined (and has notified the owner bleach ol'the IIAI mmii not. and the family of such determination) that approving f. The PHA's exercise or non-exercise of any right or rental of the unit, notwithstanding such relationship, remedy for owner breach of the HAP contract is not a would provide reasonable accommodation for a family waiver of the right to exercise that of any other right or member who is a person with disabilities. remedy at any time. 9. Prohibition of Discrimination.In accordance with 11. PHA and HUD Access to Premises and Owner's Records applicable equal opportunity statutes,Executive Orders,and a. The owner must provide ally information pertinent to the regulations: HAP contract that the PHA or HUD may reasonably a. The ownem must not discriminate against any person require. because of race,color,religion,sex,national origin,age, b. The PHA, I-IUD and the Compl[oiler General of the familial status,or disability in connection with the HAP ' United States shall have full and free access to the contract. contract unit and the premises, and to all accounts and b. The owner must cooperate with the PHA and HUD inother records of the owner that are relevant to the HAP contract, including the right to examine or audit the conducting equal opportunity compliance reviews and complaint investigations in connection with the HAP records and to make copies. c. The owner must grant such access to computerized or contract other electronic records,and to any computers,equipment 10. Owner's Breach of HAP Contract or facilities containing such records,and must provide any information or assistance needed to access the records. a. Any of the following actions by the owner(including a principal or other interested party) is a breach of the 12. Exclusion of Third Party Rights HAP contract by the owner: (1) If the owner has violated any obligation under the a. The family is not a party to or third party beneficiary of HAP contract,including the owner's obligation to Part B of the HAP contract. The family may not enforce maintain the unit in accordance with the HQS. any provision of Part B,and may not exercise any right or remedy against the owner or PHA under Part B. (2) If the owner has violated any obligation under any b. The tenant or the PHA may enforce the tenancy other housing assistance payments contract under addendum (Part C of the HAP contract) against the Section 8. owner,and may exercise any right or remedy against the (3) If the owner has committed fraud, bribery or any owner under the tenancy addendum. other corrupt or criminal act in connection with c. The PHA does not assume any responsibility for injury to, any Federal housing assistance program or any liability to, any person injured as a result of the (4) For projects with mortgages insured by HUD or owner's action or failure to act in connection with loans made by HUD, if the owner has failed to management of the contract unit or the premises or with comply with the regulations for the applicable implementation of the HAP contract,or as a result of any mortgage insurance or 'loan program, with the - other action or failure to act by the owner. mortgage or mortgage note,or with the regulatory d. The owner is not the agent of the PHA, and the HAP agreement; or if the owner has committed fraud, contract does not create or affect any relationship between bribery or any other corrupt or criminal act in the PHA and any lender to the owner or any suppliers, connection with the mortgage or loan. employees, contractors or subcontractors used by the (5) If the owner has engaged ill any drug-related owner in connection with management of the contract criminal activity or any violent criminal activity. unit or the premises or with implementation of the HAP contract. Previous editions are obsolete Page 3 of 8 firm HHUD-52641 (112007) HAPPY Software ref Handbook 7420.8 13, Conflict of Interest grandchild,sister or brother of any member of the family, nit. "Covered individual"means a person or entity who is a unless the PHA has determined (and has notified the member of any of the following classes: family of such determination) that approving the (1) Any present or former member or officer of the assignment, notwithstanding such relationship, would PHA (except a PHA commissioner who is a provide reasonable accommodation for a family member participant in the program); who is a person with disabilities. f. (2) Any employee of the PHA, or any contractor, The PHA may deny approval to assign the HAP contract subcontractor or agent of the PHA, who if the owner or proposed new owner(including a principal formulates policy or who influences decisions or other interested party): with respect to the program; (l) Has violated obligations under a housing assistance (3) Any public official,member of a governing body, payments contract under Section 8; or State or local legislator, who exercises (2) Has committed fraud, bribery or any other corrupt functions or responsibilities with respect to the or criminal act in connection with any Federal program;or housing program; (4) Any member of the Congress of the United States, (3) Has engaged in any drug-related criminal activity or b. A covered individual may not have any direct or indirect any violent criminal activity; interest in the HAP contract or in any benefits or (4) Has a history or practice of non-compliance with payments under the contract(including the interest of an the HQS for units leased under the Section 8 immediate family member of such covered individual) tenant-based programs, or non-compliance with while such person is a covered individual or during one applicable housing standards for units leased with year thereafter. , , project-based Section 8 assistance or for units leased c. "Immediate family member" menus the spouse, patent uncle] any othct Pedant housing program; (including a stepparent), child (including a stepchild), (5) Has a history or practice of failing to terminate grandparent, grandchild, sister or brother (including a tenancy of tenants assisted under any Federally stepsister or stepbrother)of any covered individual. assisted housing program for activity engaged in by d. The owner certifies and is responsible for assuring that the tenant,any member of the household,a guest or no person or entity has or will have a prohibited interest, another person under the control of any member of at execution of the HAP contract,or at any time during the household that: the HAP contract term. (a) Threatens the right to peaceful enjoyment of e. If a prohibited interest occurs,the owner shall promptly the premises by other residents; and fully disclose such interest to the PHA and HUD. , (b) Threatens the health or safety of other f. The conflict of interest prohibition under this section residents, of employees of the PHA, or of may be waived by the HUD field office for good cause. owner employees or other persons engaged in g. No member of or delegate to the Congress of the United management of the housing; States or resident commissioner shall be admitted to any (c) Threatens the health or safety of,or the right to share or part of the HAP contract or to any benefits peaceful enjoyment of their residents by, which may arise from it. persons residing in the immediate vicinity of the premises;or 14. Assignment of the HAP Contract (d) Is drug-related criminal activity or violent a. The owner may not assign the HAP contract to a new criminal activity; owner without the prior written consent of the PIIA. b. If the owner requests PHA consent to assign the HAP (6) Has a history or practice of renting units that fail to contract to a new owner, the owner shall supply any meet State or local housing codes;or information as required by the PHA pertinent to the (7) Has not paid State or local real estate taxes,fines or proposed assignment. assessments c. The I-IAP contract may not be assigned to a new owner g. The new owner must agree to be bound by and comply that is debarred,suspended or subject to a limited denial with the HAP contract.The agreement must be ill writing, of participation under IND regulations(see 24 Code of and in a form acceptable to the PHA. The new owner Federal Regulations Part 24). must give the PHA a copy of the executed agreement. d. The HAP contract may not be assigned to a new owner if HUD has prohibited such assignment because: 15. Written Notices.Ally notice by the PI-lA or the owner (1) The Federal government has instituted an in connection with this contract must be ill writing adminisltativc or judicial action against the owner or proposed new owner for violation of the Fair 16. Entire Agreement: Interpretation I-Iousing Act or other Federal equal opportunity a. The HAP corttmtct contains the entire agreement between requirements,and such action is pending;or the owner and the PHA. (2) A court or administrative agency has determined b. The HAP contract shall be interpreted and implemented in that the owner or proposed new owner violated accordance with HUD requirements, including the HUD the hair Housing Act or other Federal equal program regulations at 24 Code of Federal Regulations opportunity requirements. Part 982 e. The HAP contract may not be assigned to a new owner if the new owner (including a principal or other interested party) is the parent, child, grandparent, - - Previous editions are obsoletePage 4 of 8 form HUD-52641 (1/2007) HAPPY Software ref Handbook 7420,8 1 Housing Assistance Payments Contract U.S. Department of Housing (HA') Contract and Urban Development OMB Approval No.2577-0169 • Section 8 Tenant-Based Assistance Office of Public and Indian Housing (exp.07/31/2007) Housing Choice Voucher Program Part C of HAP Contract: Tenancy Addendum c. During the term of the lease(including the initial term of the lease and any extension term),the rent to owner 1. Section 8 Voucher Program may at no time exceed: (1) The reasonable rent for the unit as most recently a. The owner is leasing the contract unit to the tenant for determined or redetermined by the PHA in occupancy by the tenant's family with assistance for a accordance with HUD requirements,or tenancy under the Section 8 housing choice voucher (2) Rent charged by the owner for comparable program' (voucher program) of the United States Department of Housing andnUrban Development unassisted units in the premises. ��) 5. Family Payment to Owner b. The owner has entered into a Housing Assistance • Payments Contract (HAP contract) with the PHA a. The family is responsible for paying the owner any under the voucher program. Under the HAP contract, portion of the rent to owner that is not covered by the the PHA will make housing assistance,payments to the PHA housing assistance payment. owner to assist the tenant in leasing the unit from the b. Each month,the PHA will make a housing assistance owner. payment to the owner on behalf of the family in accordance with the HAP contract.The amount of the 2. Lease monthly housing assistance payment will be a. The owner has given the PHA a copy of the lease, determined by the PHA in accordance with HUD including any revisions agreed by the owner and the requirements for a tenancy under the Section 8 tenant. The owner certifies that the terms of the lease voucher program. are in accordance with all provisions of the HAP e. The monthly housing assistance payment shall be contract and that the lease includes the tenancy credited against the monthly rent to owner for the addendum. contract unit. b. The tenant shall have the right to enforce the tenancy d. The tenant is not responsible for paying the portion of addendum against the owner. If there is any conflict rent to owner covered by the PHA housing assistance between the tenancy addendum and any other payment under the HAP contract between the owner provisions of the lease, the language of the tenancy and the PHA. A PHA failure to pay the housing addendum shall control. assistance payment to the owner is not a violation of the lease. The owner may not terminate the tenancy 3. Use of Contract Unit for nonpayment of the PHA housing assistance a. During the lease term, the family will reside in the payment. contract unit with assistance under the voucher e. The owner may not charge or accept,from the family program. or from any other source,any payment for rent of the b. The composition of the household must be approved unit in addition to the rent to owner. Rent to owner by the PHA. The family must promptly inform the includes all housing services, maintenance, utilities PHA of the birth, adoption or court-awarded custody and appliances to be provided and paid by the owner of a child. 011ier persons may not be added to the in accordance with the lease. household without prior written approval of the owner 'f. The owner must immediately return any excess rent and the PI-IA. payment to the tenant. c. The contract unit may only be used for residence by the PHA-approved household members.The unit must 6. Other Fees and Charges be the family's only residence. Members of the a. Rent to owner does not include cost of any meals or household may engage in legal profit making activities supportive services or furniture which may be incidental to primacy use of the unit for residence by provided by the owner. members of the family. b. The owner may not require the tenant or family d. The tenant may not sublease or let the unit. members to pay charges for any meals or supportive e. The tenant may not assign the lease or transfer the services or furniture which may be provided by the unit• owner. Nonpayment of any such charges is not grounds for termination of tenancy. 4. Rent to Owner c. The owner may not charge the tenant extra amounts a. The initial rent to owner may not exceed the amount for items customarily included in rent to owner in the approved by the PHA in accordance with I-IUD locality, or provided at no additional cost to requirements. unsubsidized tenants in the premises. h. Changes in the rent to owner shall be determined by the provisions of the lease,However, the owner may 7. Maintenance,Utilities,and Other Services not raise the rent during the initial term of the lease, a. Maintenance Previous editions are obsolete Page 5 of 8 form HUD-52641 (1/2007) HAPPY Software ref Handbook 7420.8 (1) The owner must maintain the unit and (2) The owner may terminate the tenancy during premises in accordance with the FIQS, the term of the lease if any member of the . (2) Maintenance and replacement (including household is: redecoration)must be in accordance with the (a) Fleeing to avoid prosecution,or custody or standard practice for the building concerned confinement aflet conviction, for a crime, as established by the owner. or attempt to commit a crime, that is a felony under the laws of the place from b. Utilities and appliances which the individual flees, or that, in the case of the State of New Jersey,is a high (1)" The owner must provide all utilities needed misdemeanor;or to comply with the HQS. (b) Violating a condition of probation or parole (2) The owner is not responsible for a,breach of under Federal or State law. the I-IQS caused by the tenant's failure to: (3) The owner may terminate the tenancy for (a) Pay for any utilities that are to be paid by criminal activity by a household member in the tenant accordance with this section if the owner (b) Provide and maintain ally appliances that determines that the household member has are to be provided by the tenant. committed the criminal activity, regardless of c. Family damage.The owner is not responsible for a whether the household member has been breach of the HQS because of damages beyond arrested or convicted for such activity. normal wear and tear caused by any member of the (4) The owner may terminate the tenancy during household or by a guest. the term of the lease if any member of the d. Housing services. The owner must provide all household has engaged in abuse of alcohol that housing services as agreed to in the lease. threatens the health,safety or right to peaceful enjoyment of the premises by other residents. 8. Termination of Tenancy by Owner d. Other good cause for ternctination of tenancy a. Requirements. The owner may only terminate the (1) During the initial lease term,other good cause tenancy in accordance with the lease and HUD for termination of tenancy must be something requirements the family did or failed to do. b. Grounds. During the term of the lease(the initial (2) During the initial lease term or during any term of the lease or any extension term),the owner extension term,other good cause includes: may only terminate the tenancy because of: - (a) Disturbance of neighbors, (1) Serious or repeated violation of the lease; (b) Destruction of property,or (2) Violation of Federal, State, or local law that (c) Living or housekeeping habits that cause imposes obligations on the tenant in damage to the unit or premises. connection with the occupancy or use of the (3) After the initial lease term, such good cause unit and the premises; includes: (3) Criminal activity or alcohol abuse (as (a) The tenant's failure to accept the owner's provided in paragraph c);or offer of a new lease or revision; (4) Other good cause (as provided in paragraph (b) The owner's desire to use the unit for d). personal or family use or for a purpose c. Criminal activity or alcohol abuse. other than use as a residential rental unit; (1) The owner may terminate the tenancy during or the term of the lease if any member of the (e) A business or economic reason for household,a guest or another person under a termination of the tenancy(such as sale of resident's control commits any of the the property, renovation of the unit, the following types of criminal activity: owner's desire to rent the unit for a higher (a) Any criminal activity that threatens the rent). health or safety of, or the right to peaceful enjoyment of the premises by, e. Protections for Victims of Abuse. , other residents (including property management staff residing on the (1) An incident or incidents of actual or threatened premises); domestic violence, dating violence, or stalking will (b) Any criminal activity that threatens the not be construed as serious or repeated violations of health or safety of, or ,the right to the lease or other "good cause"for termination of peaceful enjoyment of their residences the assistance,tenancy,or occupancy rights of such by, persons residing in the immediate a victim. vicinity of the premises; (2) Criminal activity directly relating to abuse, engaged (c) Any violent criminal activity on or near in by a member of a tenant's household or any guest the premises;or or other person under the tenant's control, (d) Any drug-related criminal activity on or near the premises. . Previous editions are obsolete 6 of 8 form HUD-52641(1/2007) ' HAPPY Software ref Handbook 7420.8 • shall not be cause for termination of assistance, f. Eviction by court action. The owner may only evict the tenancy, or occupancy rights if the tenant or an tenant by a court action. immediate member of the tenant's family is the g. Owner notice of grounds victim or threatened victim of domestic violence, (1) At or before the beginning of a court action to dating violence,or stalking. evict the tenant, the owner must give the (3) Notwithstanding any restrictions on admission, tenant a notice that specifies the grounds for occupancy, or terminations of occupancy or termination of tenancy. The notice may be assistance,or any Federal,State or local law to the included in or combined with any owner contrary, a PHA, owner or manager may eviction notice. "bifurcate" a lease, or otherwise remove a • (2) The owner must give the PHA a copy of any household member from a lease,without regard to owner eviction notice at the same time the whether a household member is a signatory to the owner notifies the tenant, lease, in order to evict, remove, terminate (3) Eviction notice means a notice to vacate, or a occupancy rights, or terminate assistance to any complaint or other initial pleading used to individual who is a tenant or lawful occupant and begin an eviction action under State or local who engages in criminal acts of physical violence law. against family members or others.This action may be taken without evicting, removing, terminating 9. Lease:Relation to HAP Contract assistance,to, or otherwise penalizing the victim of If the HAP contract terminates for any reason, the lease terminates the violence who Is also a lennnl of lawtld automatically. occupant. Such eviction, removal, termination of occupancy rights, or termination of assistance shall 10. PHA Termination of Assistance be effected in accordance with the piocedures prescribed by Federal, State, and local law for the The PHA may terminate program assistance for the family for any termination of leases or assistance under the grounds authorized in accordance with HUD requirements.If the PHA housing choice voucher program. terminates program assistance for the fatally, the lease terminates automatically. (4) Nothing in this section may be construed to limit the authority of a public housing agency,owner,or 11. Family Move Out manager, when notified, to honor court orders The tenant must notify the PHA and the owner before the family moves addressing rights of access or control of the out of the unit. . property,including civil protection orders issued to p►otect the victim and issued to address the 12. Security Deposit distribution or possession of property among the a. The owner may collect a security deposit from the household members in cases where a family breaks up. tenant. (However, the PHA may prohibit the owner from collecting a security deposit in excess of private (5) Nothing in this section limits any otherwise market practice, or in excess of amounts charged by available authority of an owner or manager to evict the owner to unassisted tenants. Any such or the public housing agency to terminate assistance PHA-required restriction must be specified in the to a tenant for any violation of a lease not premised HAP contract.) on the act or acts of violence in question against the b. When the family moves out of the contract unit,the tenant or a member of the tenant's household, owner, subject to State and local law, may use the provided that the owner, manager, or public - security deposit,including any interest on the deposit, housing agency does not subject an individual who as reimbursement for any unpaid tent payable by the is or has been a victim of domestic violence,dating tenant,any damages to the unit or any other amounts violence,or stalking to a more demanding standard that the tenant owes under the lease. than other tenants in determining whether to evict c. The owner must give the tenant a list of all items or terminate. charged against the security deposit,and the amount of each item After deducting the amount, if any, (6) Nothing in this section may be construed to limit used to reimburse the owner, the owner must the authority of an owner or manager to evict, or promptly refund the full amount of the unused the public housing agency to terminate assistance, balance to the tenant. to any tenant if the owner, manager, or public d If the security deposit is not sufficient to cover housing agency can demonstrate an actual and amounts the tenant owes under the lease,the owner imminent threat to other tenants or those employed may collect the balance from the tenant. at or providing service to the property if the tenant is not evicted or terminated from assistance. 13. Prohibition of Discrimination (7) Nothing in this section shall be construed to In accordance with applicable equal opportunity statutes, Executive supersede any provision of any Federal, State, or Orders, and regulations, the owner must not discriminate against any local law that provides greater protection than this , person because of race,color,religion,sex,national origin,age,familial section for victims of domestic violence, dating status or disability in connection with the lease. violence,or stalking. • • 14. Conflict with Other Provisions of Lease Previous editions are obsolete Page 7 of 8 form HUD-52641 (1/2,007) HAPPY Software ref Handbook 7420.8 • a. The leuus of the tenancy addendum are pieseribed Housing quality standards(FIQS).The JIUD minimum quality by HUD in accordance with Federal law and standards for housing assisted under the Section 8 tenant-based programs. regulation, as a condition for Federal assistance to HUD.The U.S.Department of Housing and Urban Development. the tenant and tenant's family under the Section 8 HUD requirements.HUD requirements for the Section 8 program. voucher program. HUD requirements are issued by HUD headquarters,as regulations, b. In case of any conflict between the provisions of the Federal Register notices or other binding program directives• tenancy addendum as required by HUD, and any Lease.The written agreement between the owner and the tenant for the other provisions of the lease or any other agreement lease of the contract unit to the tenant.The lease includes the tenancy between the owner and the tenant,the requirements addendum prescribed by HUD. of the 1-ND-required tenancy addendum shall 'control. PHA.Public Housing Agency. Premises.The building or complex in which the contract unit is located, 15. Changes in Lease or Rent including common areas and grounds. a. The tenant and the owner may not make any change Program.The Section 8 housing choice voucher program. in the tenancy addendum. However, if the tenant Rent to owner.The total monthly rent payable to the owner for the and the owner agree to any other changes in the contract unit.The rent to owner is the sum of the portion of rent payable lease, such changes must be in writing, and the by the tenant plus the PHA housing assistance payment to the owner. • owner must immediately give the PI-IA a copy of Section 8.Section 8 of the United States I-Iousing Act of 1937(42 United such changes. The lease, including any changes,, States Code 1437f). must be in accordance'with the requirements of the Tenant.The family member(or members)who leases the unit from the tenancy addendum. • owner. b. In the following cases,tenant-based assistance shall •Voucher program.The Section 8 housing choice voucher program. not be continued unless the PHA has approved a Under this program,HUD provides funds to an PHA for rent subsidy on new 'tenancy in accordance with program behalf of eligible families.The tenancy under the lease will be assisted • requirements and has executed a new HAP contract with rent subsidy for a tenancy under the voucher program. with the owner: (1) If there are any changes in lease requirements governing tenant or owner responsibilities for utilities or appliances; (2) If there are any changes in lease provisions governing the term of the lease; (3) If the family moves to a new unit,even if the unit is in the same building or complex. c• PHA approval of the tenancy, and execution of a new HAP contract, are not required for agreed changes in the lease other than as specified in paragraph b. d. The owner must notify the PHA of any changes in • the amount of the rent to owner at least sixty days before any such changes go into effect, and time amount of the rent to owner following any such agreed change may not exceed the reasonable tent for the unit as most recently determined or redetermined by the PHA in accordance with /-IUD requirements. • 16. Notices Any notice under the lease by the tenant to the owner or by the owner to the tenant must be in writing 17. Definitions Contract unit.The housing unit rented by the tenant with assistance under the program. Family.The persons who may reside in the unit with assistance under the program. HAP contract.The housing assistance payments contract between the PHA and the owner.The PHA pays housing assistance payments to the owner in accordance with the HAP contract. Household.The persons who may reside in the contract unit.The household consists of the family and any PHA-approved live-in aide. (A live-in aide is a person who resides in the unit to provide necessary ' supportive services for a member of the family who is a person with disabilities.) Previous editions are obsolete Page 8 of 8 form HUD-62641(1/2007) HAPPY Software ref Handbook 7420.8 Residential Lease and Tenancy Addendum Tenant ID V19bA Part A of Lease: Contract Information Automatic Renewal 1. Contents of Lease. The lease consists of: After the initial lease term, the lease term shall renew automat- Part A: Contract inibrmatiorn ically as follows: Part B: Tenancy addendum(lease language required by HUD) After the initial term of the lease as stated in Section 1 of the Part C: The following additional provisions (as required by Lease Addendum,the term of this lease shall renew the owner): (Specify'any additional provisions e.g., automatically on a month-to-month basis. by designating any exhibits or attachments to the lease.) 6. Rent to Owner The initial rent to owner is $1,025.00 •. The amount of the rent to owner is subject to change during the lease term in accordance with this lease. 2. Parties to Lease 7. Utilities and Appliances Tenant Barbara J.Sailor The owner shall provide or pay for the-utilities and appliances as indicated below by an "0" without any additional charge to the tenant The tenant shall provide or pay for the utilities and Owner Frances Coutts Family Trust appliances as indicate below by a"T". 3. Unit Rented. This is a lease for the following dwelling unit: Address 1570 Factory Avenue Provided or Item Type Paid For Apartment Heating Natural Gas T City Mattituck State NY ZIP 11952 Cooking Natural Gas T 4. Members of Household. Other Electric T The following persons may reside in the unit. No other persons Water Heating Electric T may reside in the unit without prior written approval by the owner. Water 0 Barbara J.Sailor Sewer O Brian Husfeldt Trash Collection T Range Refrigerator Other ,8. Security Deposit The Security Deposit is - $0.00 The tenant has paid the security deposit to the owner. - 9. Other Owner Charges 5. Term of Lease (Insert description of any other owner charges that may be The initial lease term begins on 0810112007 , , assessed for items not included in rent to owner.) The initial lease term ends on 0713112008 • Residential Lease Lease for Voucher Tenancy U.S. Department of Housing ,, and Urban Development Section 8 Tenant-Based Assistance Office of Public and Indian Housing Housing Choice Voucher Program Tenant ID V190A Part B of Lease: Tenancy Addendum 1. Section 8 Voucher Program c. During the term of the lease(including the initial term , of the lease and any extension term),the rent to owner a. The owner is leasing the contract unit to the tenant for may at no time exceed: occupancy by the tenant's family with assistance for a (1) The reasonable rent for the unit as most recently tenancy under the Section 8 housing choice voucher determined or redetermined by the PHA in program (voucher program) of the United States accordance with HUD requirements,or Department of Housing and Urban Development (HUD) (2) Rent charged by the owner for comparable b, The owner has entered into a Housing Assistance unassisted units in the premises. Payments Contract (HAP contract) with the PHA 5 Family Payment to Owner under the voucher program Under the HAP contract, Y the PHA will make housing assistance payments to the a. The family is responsible for paying the owner any owner to assist the tenant in leasing the unit from the portion of the rent to owner that is not covered by the owner. PHA housing assistance payment. b. Each month, the PI IA will (make a housing assistance • 2. Lease payment to the owner on behalf of the family in a. The owner has given the PHA a copy of the lease, accordance with the(-IAP contract.The amount of the including any revisions agreed by the owner and the monthly housing assistance payment will be tenant. The owner certifies that the terms of the lease . determined by the PHA in accordance with )=IUD are in accordance with all provisions of the HAP requirements fat a tenane), under the Section 8 contract and that the lease includes the tenancy voucher program. addendum. c. The monthly housing assistance payment shall be b. The tenant shall have the right to enforce the tenancy credited against the monthly rent to owner for the addendum against the owner If there is any conflict contract unit. between the tenancy addendum and any other d. The tenant is not responsible for paying the portion of provisions of the lease, the language of the tenancy rent to owner covered by the PHA housing assistance ' addendum shall control, payment under the HAP contract between the owner and the PHA. A PHA failure to pay the housing 3. Use of Contract Unit assistance payment to the owner is not a violation of a. During the lease term, the family will reside in the the lease. The owner may not terminate the tenancy contract unit with assistance under the voucher for nonpayment of the PHA housing assistance program. payment. b. The composition of the household must be approved e. The owner may not charge or accept,from the family by the PHA. The family must promptly inform the or from any other source,any payment for rent of the PHA of the birth, adoption or court-awarded custody unit in addition to the tent to owner. Rent to owner of a child. Other persons may not be added to the , includes all housing services, maintenance, utilities household without prior written approval of the owner and appliances to be provided and paid by the owner and the PHA. in accordance with the lease. c. The contract unit may only be used for residence by f. The owner must immediately return any excess rent the PHA-approved household members.The unit must payment to the tenant. be the family's only residence. Members of the household may engage in legal profit making activities 6. Other Fees and Charged incidental to primary use of the unit for residence by a. Rent to owner does not include cost of any meals or members of the family. supportive services or furniture which may be d. The tenant may not sublease or let the unit. provided by the owner. e. The tenant may not assign the lease or transfer the b. The owner may not require the tenant or family unit. members to pay charges for any meals or supportive • services or furniture which may be provided by the 4. Rent to Owner owner. Nonpayment of any such charges is not a. The initial rent to owner may not exceed the amount grounds for termination of tenancy. approved by the PHA in accordance with HUD c. The owner may not charge the tenant extra amounts requirements. for items customarily included in rent to owner in the b. Changes in the rent to owner shall be determined by locality, or provided at no additional cost to the provisions of the lease.However,the owner may unsubsidized tenants in the premises not raise the rent during the initial term of the lease. , 7. Maintenance,Utilities,and Other Services a. Maintenance ' Residential Lease . '(1) The owner must maintaii unit and (2) The ov..._. :nay terminate the tenancy during premises in accordance with the IIQS. the term of the lease if any member of the (2) Maintenance and replacement (including household is: redecoration)must be in accordance with the (a) Fleeing to avoid prosecution,or custody or standard practice for the building concerned confinement atter conviction, for a crime, as established by the owner. or attempt to commit a crime, that is a felony under the laws of the place from b. Utilities and appliances which the individual flees, or that, in the case of the State of New Jersey,is a high (I) The owner must provide all utilities needed misdemeanor;or to comply with the HQS. (b) Violating a condition of probation or parole (2) The owner is not responsible for a bleach of under Federal or State law. the HQS caused by the tenant's failure to: (3) The owner may terminate the tenancy for (a) Pay for any utilities that arc to be paid by criminal activity by a household member in the tenant. accordance with this section if the owner (b) Provide and maintain any appliances that determines that the household member has are to be provided by the tenant, committed the criminal activity, regardless of c. Family damage. The owner is not responsible for whether the household member has been a breach of the HQS because of damages beyond arrested or convicted for such activity. normal wear and tear caused by any member of the (4) The owner may terminate the tenancy during household or by a guest. • the term of the lease if any member of the d. Housing services. The owner must provide all household has engaged in abuse of alcohol that housing services as agreed to in the lease. threatens the health,safety or right to peaceful enjoyment of the premises by other residents. 8. Termination of Tenancy by Owner d. Other good cause for termination of tenancy a. Requirements. The owner may only terminate the (1) During the initial lease term, other good cause tenancy in accordance with the lease and HUD for termination of tenancy must be something requirements. the family did or failed to do. b. Grounds. During the term of the lease (the initial (2) During the initial lease term or during any term of the lease or any extension term),the owner extension terra,other good cause includes: may only terminate the tenancy because of: (a) Disturbance of neighbors, (1) Serious or repeated violation of the lease; (b) Destruction of property,or (2) Violation of Federal,State, or local law that' (c) Living or housekeeping habits that cause imposes obligations on the tenant in damage to the unit or premises. connection with the occupancy or use of the (3) After the initial lease term, such good cause unit and the premises; includes: (3) Criminal activity or alcohol abuse (as (a) The tenant's failure to accept the owner's provided in paragraph c);or offer of a new lease or revision; (4) Other good cause (as provided in paragraph (b) The owner's desire to use the unit for d). personal or family use or for a purpose c. Criminal activity or alcohol abuse. other than use as a residential rental unit; •(1) The owner may terminate the tenancy during or the term of the lease if any member of the (c) A business or economic reason for household,a guest or another person under a termination of the tenancy(such as sale of resident's control commits any of the the property, renovation of the unit, the following types of eliminal activity: owncl'a desire to rent the unit for a higher' (a) Any criminal activity that threatens the rent). health or safety of, or the•right to peaceful enjoyment of the picmiscs by, c. Protections for Victims of Abuse. • other residents (including property management staff residing on the (1) An incident or incidents of actual or threatened premises); domestic violence, dating violence, or stalking will (b) Any criminal activity that threatens the not be construed as serious or repeated violations of health or safety of, or the right tothe lease or other "good cause" for termination of peaceful enjoyment of their residences the assistance,tenancy, or occupancy rights of such by, persons residing in the immediate a victim. vicinity of the premises; (2) Criminal activity directly relating to abuse, engaged (c) Any violent criminal activity on or near in by a member of a tenant's household or any guest the premises;or or other person under the tenant's control, (d) Any drug-related criminal activity on or near the premises. , Residential Lease ' shall not be cause for termination' of assistance, f. Eviction by court action. The owner may only evict the tenancy, or occupancy rights if the tenant or an tenant by a court action. immediate nrcn►bc► of the tenant's family is the g. Owner notice of grounds victim or threatened victim of domestic violence, (1) At or before the beginning of a court action to dating violence,or stalking evict the tenant, the owner must give the tenant a notice that specifies the grounds for (3) Notwithstanding any restrictions on admission, termination of o occupancy, or terminations of occupancy or tenancy. The notice may assistance,or any Federal,State or local law to the included in or combined with any owner eviction notice. contrary, a PHA, owner or manager may "bifurcate" a lease, or otherwise remove a (2) The owner must give the PHA a copy of any household member from a lease,without regard to owner eviction notice at the same time the whether a household member is a signatory to the owner notifies the tenant. lease, in order to evict, remove, terminate (3) Eviction notice means a notice to vacate, or a occupancy rights, or terminate assistance to any complaint or other initial pleading used to individual who is a tenant or lawful occupant and begin an eviction action under State or local who engages in criminal acts of physical violence law. against family members or others. This action may be taken without evicting, removing, terminating 9. Lease:Relation to HAP Contract assistance to,or otherwise penalizing the victim of If the HAP contract terminates for any reason, the lease terminates the violence who is also a tenant or lawful automatically. occupant. Such eviction, removal, termination of occupancy rights,or termination of assistance shall 10. PHA Termination of Assistance be effected in accordance with the procedures prescribed by Federal, State, and local law for the The PHA may terminate program assistance for the family for any termination of leases or assistance under the grounds authorized in accordance with HUD requirements. If the PHA housing choice voucher program. ' terminates program assistance for the family, the lease terminates automatically. (4) Nothing in this section may be construed to limit the authority of a public housing agency,owner,or 11. Family Move Out manager, when notified, to honor court orders The tenant must notify the PHA and The owner before the family moves addressing rights of access or control of the ' out of the unit. property,including civil protection orders issued to protect the victim and issued to address the 12. Security Deposit distribution or possession of property among the a. The owner may collect a security deposit from the household members in cases where a family breaks tenant. (However,the PHA may prohibit the owner up from collecting a security deposit in excess of private (5) Nothing in this section limits any otherwise market practice, or in excess of amounts charged by available authority of an owner or manager to evict the owner to unassisted tenants. Any such or the public housing agency to terminate assistance PHA-required restriction must be specified in the to a tenant for any violation of a lease not premised HAP contract.) on the act or acts of violence in question against the b. When the family moves out of the contract unit,the tenant or a member of the tenant's household, owner, subject to State and local law, may use the provided that the owner, manager, or public security deposit,including any interest on the deposit, housing agency does not subject an individual who , as reimbursement for any unpaid rent payable by the is or has been a victim of domestic violence,dating tenant,any damages to the unit or any other amounts violence,or stalking to a more demanding standard that the tenatit owes under the lease. than other tenants in determining whether to'evict c. The owner must give the tenant a list of all items or terminate. charged against the security deposit,and the amount of each item. Atter deducting the amount, if any, (6) Nothing in this section may be construed to limit used to reimburse the owner, the owner must the authority of an owner or manager to evict, or promptly refund the full amount of the unused the public housing agency to terminate assistance, balance to the tenant. to any tenant if the owner, manager, or public d. If the security deposit is not sufficient to cover housing agency can demonstrate an actual and amounts the tenant owes under the lease,the owner imminent threat to other tenants or those employed may collect the balance from the tenant. at or providing service to the properly if the tenant is not evicted or terminated from assistance. 13. Prohibition of Discrimination (7) Nothing in this section shall be construed to In accordance with applicable equal opportunity statutes, Executive supersede any provision of nny Federal, State, or' Orders, and regulations, the owner must not discriminate against any local law that provides greater protection than this person because of race,color,religion,sex,national origin,age,familial section for victims of domestic violence, dating status or disability in connection with the lease. violence,or stalking. 14. Conflict with Other Provisions of Lease Residential Lease 1.00v c..n....,... Pape 4 of 6 ri. The terms of the tenancy addendum are prescribed Housing quality standards(HQS).The HUD minimum quality by HUD in accordance with Federal law and standards for housing assisted under the Section 8 tenant-based programs. regulation, as a condition for Federal assistance to HUD.The U.S.Department of Housing and Urban Development. the tenant and tenant's family under the Section 8 HUD requirements.HUD requirements for the Section 8 program. voucher program. HUD requirements are issued by HUD headquarters,as regulations, b. In case of any conflict between the provisions of the Federal Register notices or other binding program directives. tenancy addendum as required by HUD, and any Lease.The written agreement between the owner and the tenant for the other provisions of the lease or ally other agreement lease of the contract unit to the tenant.The lease includes the tenancy between the owner and the tenant,the requirements addendum prescribed by HUD. ,'of the I-IUD-required tenancy addendum shall PHA.Public Housing Agency. control. Premises.The building or complex in which the contract unit is located, 15. Changes'in Lease or Rent including common areas and grounds. a. The tenant and the owner may riot make any change Programa The Section 8 housing choice voucher program. in the tenancy addendum, However, if the tenant Rent to owner.The total monthly tent payatle to the owner for the and the owner agree to any other changes in the contract unit.The rent to owner is the sum of the portion of rent payable lease, such changes must be in writing, and the by the tenant plus the PHA housing assistance payment to the owner. owner must immediately give the PHA a copy of Section 8.Section 8 of the United States Housing Act of 1937(42 United such changes, The lease, including any changes, States Code 14370. must be in accordance with the requirements of the Tenant.The family member(or members)who leases the unit from the Icnaucy addendum. muck b. In the following cases, tenant based assistance shall Voucher program.The Section 8 housing choice voucher program. not be continued unless the PITA has approved a Under this program,HUD provides funds to an PI-IA for rent subsidy on new tenancy in accordance with program behalf of eligible families.The tenancy under the lease will be assisted requirements and has executed a new HAP contract with rent subsidy for a tenancy under the voucher program with the owner: (1) If there are any changes in lease requirements governing tenant or owner responsibilities for utilities or appliances; (2) If there are any changes in lease provisions governing the term of the lease; (3) If the family moves to a new unit,even if the • unit is in the same building or complex. c. PHA approval of the tenancy, and execution of a new HAP contract, are not required for agreed • changes in the lease other than as specified in paragraph b. d. The owner must notify the PHA of any changes in ' the amount of the rent to owner at least sixty days before any such changes go into effect, and the amount of the rent to owner following any such agreed change may not exceed the reasonable refit • for the unit as most recently •determined or • • redetermined by the PHA hi accordance with HUD requirements. 16. Notices Any notice under the lease by the tenant to the owner or by the owner to the tenant must be in writing. 17. Definitions Contract unit.The housing unit rented by the tenant with assistance under the program. - Family.The pet sons who may reside in the unit with assistance under the program. HAP contract.The housing assistance payments contract between the PIIA and the owner.The PHA pays housing assistance payments to the owner in accordance with the HAP contract. 'Household.The persons who may reside in the contract unit.The household consists of the family and any PHA-approved live-in aide. (A live-in aide is a person who resides in the unit to provide necessary - supportive services for a member of the family who is a person with disabilities.) Residential Lease o .oma r a Signatures.' Tenant Owner ' Barbara J.Sailor , Frances Coutts Family Trust Print or Type Nam f Tenant Pr! • Type Nap/O. Owner fpo a.4 C/4 iz2 , -041 .1-114e (-41.‘,/he c,k al-- Signature J •:�'re / r j1 � / / Date / Print or •=WI/ `nd Title of Signatory F' P7 Date • • Residential Lease 6 Disc,nsure of Information on Lead-Based Paint and Lead-Based Paint Hazards Tenant ID V190A Lead Warning Statement ' Housing built before 1978 may contain lead-based paint. Lead from paint, paint chips, and dust can pose health hazards if not taken care of properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing,owners must disclose the presence of known lead-based paint and lead-based paint hazards in the dwelling. Tenants - must also receive a federally approved pamphlet on lead poisoning prevention. Owner's Disclosure (a) Presence of lead-based paint hazards(please check one box below): . Li Known lead-based paint and/or lead-based paint hazards are present in the housing(Please explain). ❑ Owner has no knowledge of lead-based paint and/or lead-based paint hazards in the housing. (b) Records and reports available to owner(please check one below): Owner has provided the tenant with all available records and reports pertaining to lead-based paint and/or lead-based paint hazards in the housing(please list documents provided below). • • - Owner has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the . housing. - Tenant's Acknowledgment . (c) Tenant has received copies of all information listed above. (d) Tenant has received the pamphlet Protect your Family from Lead in your Home from the Housing Agency. Housing Agency's Acknowledgment - (e) Housing Agency has informed the tenant of the owner's obligations under 42U.S.C.4852(d)and is aware of agency's responsibility to ensure compliance. Certification of Accuracy • . • The following parties have reviewed the Information above and certify,the,the best of their knowledge,that the information provided by those signing this document is true and accurate. SIS: atures _ Ho sing Agency Representative . Tenant Owner No h Fork Houma I Alliance, IncA Barbara J.Sailor Frances Coutts amlly Trust ` Print•r Type, - SI Print or T pe Name/of Tenant O Print or Type Name of Owner c _.) Q_, 7.4„(.) • TsiCIJi Signature Sig lure - gnalu/ /' Tanya P. ore,Executive Director ( ,;Z_, a )421L.< 0.< •#,. Printr Type Na a and Title of Signatory Date � I I or •. •.:Name a d Title or Ignnal/ory Lam, (9-Li czfi DaleDateQ V 2 f o7 0 HAPPY Software Page 1 of 1 r 3189 OFFICE LOCATION: TOWN OF SOUTHOLD OFFICE HOURS&PHONE 53095 ROUTE 25 CONSOI m N.TED REAL PROPERTY TAX BILL MON-FRI 8.00 AM TO 4:00 PM SOUTHOLD,NY 11971-0499 DECEMBER 1,2005- EMBER 30,2006-TAXES BECOME A LIEN DECEI1 L 2005 631-765-1803 FAX:631-765-5189 SUFFOLK COUNTY TAX MAP NUMBER IF THE WORD"ARREARS"IS PRINTED L CODE AC(OUNT NUMBER BILL NUMBER ' COUNTY TREASURER'S NOTICE ON REVERSE SIDE. 473889 142.-1-3.3 382 17182 .PROPERTY LOCATION ACRES EXEMPTION DESCRIPTION lL?XEMPTION AMOUN" EXEMPTION PURPOSE AGED-ALL 'Wm' 1,400 COUNTY 1570 Factory Ave 0.4 AGED-ALL • 1,400 SCHOOL-f-`"` 1,400 TOWN-'` +� COUNTY AID TOWN AID BANK CODE AGED-ALL '1� STAR(EN 1 L / 1X4"50" ---7 -(I SCHOOL " 293,911,657 2,761,603 I ! 1'' ' 100 PROPERTY CODE ROLL SECT PROPERTY TYPE XU:4 ' * ' \ oc1 VI' 210 1 1 Family Res ! 9Y F`��.4DI I 111 II III I 11 I1 I111 1' III 11I ' I III I III III WARRANT DATE LAND ASSESSMENT TOTAL ASSESSMENT 111 1 11 111 1 11 1 111 11 1 111 1 1 ,,,,,,-4,q,:;:.-..s 0000004615 AUTO**5-DIGIT 11952 12/6/05 300 >-y 2,800 Coutts Frances T19 P1 • I L14:Irlri•0relzr»113r_illiz Lr_vr •i.Inwr_mimi.oisi.. Factory Ave PO Box 746 COUttS, Frances t:IUttituck,NY 11952-0746 2004-2005 TAX PAYMENT INFORMATION NOTICE OF.ASSESSED VALUE 3_,' '`f.:-F-1-..".• :�_; -r _ ,FE:_ • ,:# :,c:; ^,ir'' - = ,;a:F•-„ ;ASSESSED`'VALUE'.1* -t"„s�' ':.RATIO,.!:,:-., - ry' -100%OF,FULL VALUE: °F ,•3` - - e - - ^t"sem...,,- _ _ i�st.Half�- `-17131:5; 3:8 _ / /0 ,:.7--r..1-.--',.',,----!-, 5 r - WHICH'- - �.fa - �'2'800-- '.,,.'1; /•o�,of ifs! x{ - - ?4. f' xi' �ri k:'• 1Y f•- -17. 3�- �30381�':r=-! 1�4%05.� '-Second�'Hal 1 1a _$ ;': >; -r �;::�.'<;is:�:' �. -t S .. ,'"Hr � %' "',I' �-r; �, vS.r� '' ". t"""-"riLEV�_DCSCliI1t�U'-<- .%,LEVY' o:�--='-%;`AXAL ".VA=UE�_:�: :RAKF0..,.;y,,_FRbCoRCARz`= . ;,1AXAM-UUFiS;*t= zr','' >iOTALTA+AM-OUN_t ,- "- i s �' " -_ FYI'r.'",`i 0 i ^iyr-i_- 1'; ' ,},t}:_ : - - ` : /^'S',-i i)'i � " 0�`- ,'"'•� •,+' ' .'-''',.-4,-::4`,-; - ,MattituckSctoo" - t r/:„ � 0:00/� ';.1L:' -v~' ix633:31 6 ^ 1-,,,:,f,-Z4,0 .`2 40 d'; ;d{e' �a. d•4 t •�0 f ! .I: �' .�" i. i:al'; "Mattifuck"Libra •8. 6/o -s1;4OO .� � :'411:6T;, >`5: 0/ : -,: • 57:63,' t� `+ Y; rs 9 Ji ^ * - ` . `,YM:,4;, y , Mfr ;.�-�� - rr.'wi+I Jil ' i-,--„1,..',,,r--_,' - �- ▪ Ji • jx•• tz �n - � ;i i ' -t i',.,,,,:{- KdYourtaa ;vin:stSisw�ea��resulliri• from'the.New�York�State�'chool`TaRelief' STAR :�o:-ramis•$886:64 ":-:�'. cnd. _._t}���;-<• TAX LEVIED 8.66% FOR SCHOOL 57.63 �, .).:- -• - .1-•:•.,1.. -1-,t-.17..-:',.... 76-,.., F'. p '''•••'''1;r4,'-',';','''''•:;P;;41'',L'!„,i :1 ,'S .t,I.. ,K! 9=• �''i i1. r '�ys'� �.ac ,i'i- � T 'F 'e, 1, Suffolk..Cou"nt' Tax• `�r,-,� � :.#•`:'' '1':60/o! ='i'' ,1'.4'00. ^}t': ' - - -12:30' �'1' :62'� �=,° i <�!•'.`i+ F'' ,5.. HL.•V .'7 :R.T'1'>};�`,'j. '{i',--. ,T;':1. .f.Y I':,;':,tiii,i'": ia.�i .••S`>• - i."'ai • _ 's• - ,;,' _ �5�`.,-,,'• _ ".;,y •_ ,•,=Y�r:r "r,'c,„7_ .ps•..J y>'_'-i''.:L':'.;i ,,''': '.+r. ,1r. %.:: .�=' �41 ly ,'r.' -W>� .V y 2.f.`T.,' ' ''-,',/*' (.. 'Ygi'�1 - i.t:,,a `'Tt_ .•r'A!-_.`i7'f v • 2�x `.`t'" � ,.i"' 'iy _ .. .... ".?' .}f'�µ� �>..rU.l`- ,> - 'lr ,. �; ., ,�f.i;%:Ir,,1',V!,';'[..€. ,e,,, ��t,^,,,• ;i.r 'TAX LEVIED 1.60% ' FOR COUNTY' , 10.62 '= - 'c = '.r ,a., - , f. - '-YM ''s:,, ..'i't:r.rY` ; „l_ - -gip, -'y._ _ t'r.f:r,`..'''w� ,-,-' r5;'.+'" .ii ;,2.ic,"•,:.1!",p-; `- �SoutholdTown__ �' - _ 1,=� -�,� ;,---:-:.1;',-.-i,,,-4.., ';''''''''''''f'1;,.x.;�;�;_ , ,.,, r. ;o, 5�F : , � � ��,. .; Tax ":1;' 39 1�0%4. _ Kr1.;4,00 ;.v �7;;�,185t 9,48. ,2_:60/o- :�, 260:3$ >�;,,.; :r�- , ,':4;,-::,----:-' ',,,, -'----''4.--:2-.-'-'..P 1,- .� -..,..44i 4-:f,le i �f",Y;•p' S'y' Y:�r '•* 311 ,,,,.. ., r.t ;5.,[a-tt,./.t,'^{ '�� ;�„ 1 teri. 4' TAX LEVIED 39.10% FOR TOWN 260.33 r. NYS Re--- -- TaxLa, '''''""6:666/'-'F5 '• 1'.400' 2:370 4 'f`{ _`1'.60' _ =-„ c“'i'y 't -P- ,f: _nY." - ,}«ip4 :'F{; :;.', _ ,/o. ,�r;�„ ':3:32',1� �`1:-;,•-• S anda#ed:Ex,-ansa' -3:04/0 �1`�'40•0 ��`� • ''1.'450:` - -f•.- - -,�.�.;•�° 4.., - _252`.50./os`"' -20:23"; ;,.. F:'- - ate U �tt•t' _ Ma I uck'FD 32='24 /o:�'+ a2 800;` .76:651= ....:4i-it--.,.32:269/df - ,'z ,s' . p!i;. '2'14:62- :-t<<' ` - j^, ",�: - ,,,,-1.4,--.4.,-,, - ..t'�:T� !' �.k '`d tip' - - 'IfLL7±�1,. Mattitl ick•Park: - 2,-8 =1= 3 .FIs,'.,. ',, /o.''2n 00. • - 7:973 = ^"4c90./d=.~ .•'50:32>�',';0''.:',j'`.•:f=-- _ -'�''' ��<� •,>�-� - '': �fir:. ';; °i_ - S-•'Yap <'.`.rr,� ; ..�:<�; 'a'': -- -�-- 7' -yc �"v :_Waste=lNater'District` • - °:i.., .=,-� •_ - '�-� - �0:10./0� -,,<'.f;: 2A800`_ -.236., -83:.40./0'= .t;-=' - `� - :i£> '.tet. �rr %»�-:x;34=a,`•;, _ _ _ _ 12'1 Z?:1�'` .€,> ',"4'44:k,:. 'r1. - O 3 _ _Y.. _ Sf, '.1 a�,n - `i I - - �'"i'e.i - �Solid"1111aste-Qi"`tact,'" ^�s� :�t'2fi - _ _ -i - .S`Fq', - - aE. '.'S.N-,. - -'_y�i'ys� - 1 -, ^f'>: Ate', f. %i r,.',,,''',-,.*% r.•'', �i1 iy.- q % .y,.' 3ja "', - aX J _ p L':' y - - , tom �l., ,.t''' lin 1 F '2f °�9:• '--,,,...--'''.".2:.- - r - f�x - • 't..r - _ Y'f. I' -fir,, I .{. �r!A1. v," -'.1.• _ ,fie. �(' - `Y.s _ y i•' . - "TAXLEVIED 50.65% FOR OTHER DISTRICTS 337.16 FIRST.:HALF.TAX '332-.87' SECOND,:HALF=TAX;..,332.87`' r'd TOTALTAX°;LEVY, 'f' 665.7,41-'""�" - '. '`'r'' _ .r,,. r - " ,, art_ - - a'-,-,;;-:;,,,: .- - - -,t r= ,de, ',.,,,,,, - f, 'i, fii. ' : ;,r-`"DUEDEC.1;2005PAYABLE.Wm-IOU1PENALTYTOJAN 10,2006 '„ DUE DEC.1,'2005PAYABL'EWITHOUTPENALTY:TOMAY,,31,2006=SEE REVERSE =" -' - i" ' '"''3; ' ''' �" 1''+' "'''4 IS TAX''MAY:BEaPAID IN,ONE'OR':TWO,INSTALLMENTS , 'SEE'REVERSE SIDE FOR-PENALTY-SCHEDULE.',-"•='•- ,� SIDE;FOR,PENALTY.:SCHEDULE AND,COUNTY,TREASURER'S,NOTICE; ,-',,,,,,f.,_ , - , OFFICE LOCATION: TOWN OF SOUTHOLD OFFICE HOURS&PHONE 53095 ROUTE 25 CONSOLIDATED REAL PROPERTY TAX BILL MON-FRI 8:00 AM TO 4.00 PM SOUTHOLD,NY 11971-0499 DECEMBER 1,2005-NOVEMBER 30,2006,-TAXES BECOME A LIEN DECEMBER 1,2005 631-765-1803 FAX:631-765-5189 SUFFOLK COUNTY TAX MAP NUMBER SCHOOL CODE IF THE WORD"ARREA' .ERE SEE ACCOUNT NUMBER BILL NUMBER . COUNTY TREASU-• -'S NOTICE ON REVERSES 473889 142.-1-3.2 382 14 17181 PROPERTY LOCATION ACRES EXEMPTION DESCRIPTIC N EXEMPTIOI I AMOU NT EXEMPTION PURPOSE • 10650 Sound Ave 0.23 i F't) air COUNTY AID TOWS AID BANK CODE r �OA kV `' —7-293,911,657 2,761,603 ` 6�6vs° �431 '�`- — T-^` PROPERTY CODE ROLL SECT PROPERTY TYPE , 311 1 Res vac land 1 OCT 1 5 2007 I l nl lIn,III I I I nI ill nI t I nIII nI nIII nIII WARRANT DATE LAND ASSESSMENT TOTAL'ASSESSMENT , � n� � , � , ni , , , , , � , 0000004614 AUTO**5-DIGIT 11952 12/6/05_41 600 LC cap;: i r``, 600 - _' Coutts Charles Jr - T19 P1 OWNER AS OF TAXABLE STATUS DATE ON MARCH 1,2005 Factory Ave -- Pr-y.Fu.ti 746 Coutts, Charles Jr ck, NY 11952-0746 2004.2.Q05 TAX PAYMENT INFORMATION NOTICE, OF ASSESSED, VALUE - . . 2t. � , '= - - .s" i - ' i __,1-•'r-4-" : . - - ac: �,;L: ":g,t5'17. �_" ':ASSESSEDVALUE;-�_ ' 'RATIO'_ '„T:-.ae -�A00/,OF FULGVALUEst , 171'30:.• ,. ,$ f4 £ -. '..r,.,;,•'1'2'',-N,... ,,, - y _ :,. ' ' . $f' 1jr 1J IS' =S_ ` � '�.'� h$econdz-Halfts._17130" -$ 90'90 � ' %4%05•>;,`�,'�.=+f, =�< ' - .'60 ;NHH"1:26/..,OITS: w47a,4<6'19` +�'; _ 1' - _�= Y-mocSCFi" i� 3nr ' = ��� � L�k'�aLev( -u�r< `PERl00�:4 �FAO�7PTOV�A �-.�.-_z,1XAMfliiiToTiL"rA%`IlI©UY1= iVattitii`k'S - ;-�' .� -63:53/d= t' X600 ->�: i331316:=; 240/ °.�•: - 379�99{' �h 0 =.Matti k' ti' .":�=` �.tr� 0 yr', tuc L ra <� ;yi,. �4�13- ji: , /o` 600 ; 41��1'6 - ..�„ ,.A .i S q !'7' biz`" .lr =i' _ ''sem f i' d,- lr," } s,•f,.S F�. 1. _ b ,,,Gf rY` - tXi f', r.: ,N :1 {Lhti;.i �5 •r.ra-w - 4 'r 3`� TAX LEVIED 67.66% FOR SCHOOL 404.69 ; - - - »T'," - +j,.-.: .•• 0-,,,-,, - - 'F!`<' - ;;. viz -'i4-`,°!. .I'e'^ ,%S. _ _-t.; .r{a _.,, ',y,. P' "rte"' +0T w I� Suffolk`Co'unY ':T _ ,-: +0:76/0� r�=�-t600r �„x- �7r g �'�._, =�<'.":t. .'4s55' �y_ tY„ t" „a_.p5 6,'. -12:30%-' i,: t ^ ' 14.s„t y. i • ,_ ....., a .J. • ° TAX LEVIED 0 76°/ FOR COUIVTYt ' :' ;r� 8 � ; .,ate .=.: � r 4k'r1'i; ` `_'� {r5outiold Town=Tax � 18:65/r ;• :,60Q• . •t15.948< �2.60% F �- ts1�11i57s . . . ,u. t , # ^ n, < .- - iii• .; . q ' • TAX LEVIED 18.65% FOR TOWN ” . : . L. f O ,4. ,,^--,;,w - :_- '•° ? ,,.. - '1 j ct ..y. Z f,., NY$Real Rr `Ta L w ;' ': : :'`i'. ,. ,,. o x a `-�`'0:24,/0,: ti00,. :,` '2:370::•;=. '{1-:60/o F= '' }.'• k P -:t• �-�m - r.,>;- .9.42`1 's'' .,.: 0 't' E�r Yi '`'l' `r. .r5 - N S`M.,., .ed'Ez' - erise: 1:45 0 �0 - .'_ / 6 0:^ �=14.450:" `25:5 '; :;',,,i - '''�5'ry ,szi' ,sib,` i,- r'i�.`,,-:".r - ,} t 1' 0 0- a - - `i- 'S�-i i' _ V"e '.M c ;7.69 ',�- `••�:. /o Oa-. ,-r,; 76.659<<" .32:20/-, x.. ;'; ".;- -r s-,'45':99>, _ miry .3-��^' -r ; ar§. -i d Mattituck.Pa� - r5. k ., :1`.80 0'�= �0 "�_:.' /, �`.6 0,"': =>1Z.973° ::4:90 0< -€�,°- _ �'�� / t':zs;Aer '10�Z8' `% `:r, :' _4+,.r ".. - ',''''''',;', =';:''''''''•-,-,5, }:i `1lVaste_VVateii-DistPict� "�, 0.02 � vt 1t P`:'� A� �h.. i`-•.'-f!.'-':-'. 10 y ''e•;.,600:a'-'.=•��=:7F�- .236'.,. ,83`.`4:0/o.:`; Id ' '.}fir. c"� ',_ SO •W t t=" _ X75` !•-.',T1:7-,-1:17.2%-.: <F` ii`d. ase•bistric °'I`�:• -"600-=' .i7:i��l`"` .36190 0�'`:-a. �'� �'i - - .; . ...St.it ;kt."-- ;♦A+ -.!+ ;}.L g i .Y}� , 3 'I�': Y, 4< -fit.;1:-:;',:t.f ,..f, rf.,v _ t'Y 'w s`h1:. ~�i t f'L`_ i 'F �:j..�S` 4 „ie i 3t �'i r ` S {fit{'. - 4- 1. 1, ;S F y F"° %`ri y{ - ^ It .`q i j`` t .0 L� � S '$ y'; _ ;s'- 5 wl;: U ' TAX LEVIED 12.92% FOR OTHER DISTRICTS 77.29 t' 'F• - IRST�HALF - yT AX: , - SECOND' AX-:29905: F�s"��;;�':. ��.`��",rtTOTALTAXaEVY�'� -�59 - - - - -.,q L- 'i-Y F - 'N-•-_ 3 Ya"4'='r,':..x,.,.,'. '-a.-:. - ',a';= ;,. ,,Y l,,- .};- _ _ _ ri38,',a %,.'DUE DEC.9;2005 PAYABLE WITHOUT PENALTY TO JAN.10;2006'-'- DUE DEC"1,2005 PAYABLE WITHOUTPENALTY TO MAY31?^2006J SEE REVERSE F:-''-•-L``` "^' '"`^�``-'•'s _ • ':SEE REVERSE SIDE FOR PENALTY SCHEDULE. _ '`4"',.- SIDE'FOR,PENALTY:SCHEDULE AND COUNTY,TREASURER'S;NOTICE. ,THIS;TAX'MAYBE•PAID,°IN,ONE;ORyTWOIINSTALLMENTS,r • DDSS Lawrence Eric Davidow Harry A Davidow LawrenceA Siegel DAVIDOWDAVIDOW SIEGEL & STERN LLP (1890-1954) Steven H Stem" > > > Retired Terry Crpnam Counselors at Law•Original Firm Founded 1913 Wallace F Davidow Michelle Jablonsky Sanford L.Davidow Regina E MacKay - - Anne-Mane Monahan Gina Ram-Simms 1601 Veterans Memorial Highway•One Suffolk Square•Suite 330 ' r ' L__;) Mani Ben ass-Amt Islandia,New York 11749 Tel(631)234-3030•Fax(631)234-3140 i 0 r 1 5 2007 Website•www.davidowlaw.com ',Admitted to Florida Bar FACSIMILE TRANSMITTAL SHEET DATE: g/ 4 / 0? TO: foie p h L rl^h7c V a l C& FAX NUMBER: 51 (p a `( sac 7 TELEPHONE NUMBER: NO. OF PAGES (INCLUDING COVER SHEET): • FROM: L efte TCLb (Cfl S RE: SI 444 L tcct-roK S[azlti Tc-ft t : TgA .D - SS- 19 COMMENTS: ( ert-I `-h-- f)i"e -pnL q (9 S : 0(0._e hlap f#t•hes .- �-- m e - rmi . -*Jut. . NW r -/ hi _ CWIe . 111 • ` " 1.1. c�... `e e- � � -� hep a /-(AleSeas v) • £ 6 --61-(c .p regi `_ 62 o t pa l- protk-,J--) �� THE INFORMATION CONTAINED IN THIS FACSIMILE MESSAGE IS ATTORNEY PRIVILEGED AND CONFIDENTIAL INFORMATION INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY NAMED ABOVE.IF THE READER OF THIS MESSAGE IS NOT THE INTENDED RECIPIENT,YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION,DISTRIBUTION OR COPY OF THIS COMMUNICATION IS STRICTLY PROHIBITED.IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE IMMEDIATELY NOTIFY THE SENDER BY TELEPHONE AND RETURN THE ORIGINAL MESSAGE TO THE SENDER AT THE ABOVE ADDRESS VIA THE U.S. POSTAL SERVICE.THANK YOU. IRS Circular 230 Disclosure Pursuant to Regulations Governing Practice Before the Internal Revenue Service,any tax advice contained in this communication(including any attachments),unless explicitly provided otherwise,is not intended or written to be used,and cannot be used,for the purpose of(i)avoiding penalties under the internal Revenue Code or(ii)promoting,marketing or recommending to another party any transaction or matter aadressed herein / fes. r SINGLE AND SEPARATE SEARCH PART OF SUBJECT PREMISES District 1000 Section 142.00 Block 01.00 Lot 003.002: Nathaniel W. Williams as executor of Ada Wirth Williams Dated: 10/30/1973 To Rec'd: 11/05/1973 Charles,R. Coutts, Jr. Liber 7524 Cp 11 Frances Coutts as sole heir-at-law of Charles R. Coutts, Jr. Dated: 07/27/2006 To Rec'd: 11/16/2006 Geoffrey R. Hallenbeck, III as Trustee of the Liber 12478 Cp 941 Frances J. Coutts Family Trust LAST DEED OF RECORD / 'fit ose, ravaia v ice President Dated: 08/07/2007 • - - PART OF SUBJECT PREMISE , District 1000 Section 142.00 Block 01.00 Lot 003.003: Sadie E. Ferris Dated: 05/03/1940 To Rec'd: 05/03/1940 Charles R. Coutts, Jr. and Frances Coutts, his wife Liber 2098 Cp 28 Frances Coutts individually and as Surviving tenant by the entirety Dated: 07/27/2006 To Rec'd: 11/16/2006 Geoffrey R. Hallenbeck, III as Trustee of the Liber 12478 Cp 939 Frances J. Coutts Family Trust LAST DEED OF RECORD JCIA,71,41— i Intravaia f ice 'resident Dated: 08/07/2007 I . Bulk Schedule M _ [Added 11-28-1995 by L.L. No.23-1995; amended 7-22-1997 by L.L. No.22-1997] i Lot Size Width Depth Date of Lot-Gfeati' bv..-re-f - feet feet • Prior to April 9, 1957 Any Any Any Between April 9, 1957, and December 1, 1971 A Residential Zone 12,500100 Any B and B-1 Business Zone 7,500 50 Any B-2 Business Zone 40,000 50 Any Multiple-Residence Zone 12,500100 Any , C Industrial Zone 12,500 100 AnY Between December 2, 1971 and June 30, 1983 A Residential Zone 40,000135 175 M Light Multiple Residence 40,000135 Any M-1 Multiple Residence Zone _60,000200 Any B-Light Business Zone 20,000 60 Any B-1 General Business Zone30,000 150 Any C-Light Industrial Zone 40,000 200 Any C-1 Heavy Industrial Zone 200,00 300 Any -.. ed b ZBA Office 8/31/01 —__— _ \ . 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In —_— --L—_ a ,.ten-- —_ Oon At.0 ..,£R 0 County Center iFEETeod,NY 11901 snJoin ennui n.ILLR s PxTill n `:a .,' SCALE EI PEEi A 100D IAL., I,.T mnvRSE moo.RnET PERdsvml of TRY .o®y_-- ' P E 1° PROPERTY MAP N on,. In ,,.m s.n"t Yv—n-- W&M1.14 T[t[t[TEP .xU REAL PROPERTY TL[SERVSF,DEIST I" ' . a .“." 4l um 171 Aim or 121A Ie.. —__— , —_ _- .. . - _ [....0.2 141 LItl Tmoe,n —---- s..,.mxx.In --S— 09UTE,E A...,IM __I -+• - � , _ __ - _ - = _ ' Yr _ w W- _ - scF �sr-' ` > <z�. a ;,. • ve .;. '-n _ t?= � .>r" � +3 - 3� :+ 3n. --'-- - -.-e4.,.-.. .y ss � hp LaserJet 3380 s c/ DAVIDOW#DAVIDOW 2343140 v Sep-24-2007 4:03PM invent Fax Call Report Job Date Time Type Identification Duration Pages Result 994 9/24/2007 3.59:16PM Send 15162945227 4:29 6 OK 41 DOSS ' 1{` limy Oni1n II DAVIDOW,DAVIDOW,SIEGEL&STERN,LLP "e }WWW k°`"'• Couluelon atLaw•OHL1^dPim FoundedHD •na,1.1do. ii n. wb'OgM ae�,wlm mab .� bo c tmiatrgew�e 1501 Velem,Men6Ga%Mghway•One Sufoh Square•Stole]]0 if 340440.1 46M4o,New Yoh 11749 Mwote Tel(5X)274-]0]0•Fv(5]7)274-]140 6A1 Wasik wwwdenE000kwsom •Ab Yd to(balm • 1 FACSIMILE TRANSMITTAL SHEET v DATE: cil.24 I O? 7 TO: Toseph In-hz(vata a FAX NUMBER: 5l(P `;94 -Sao7 it 'TELEPHONE NUMBER f NO.OF PAGES(INCLUDING COVER SHEET): 1I FROM: ILA(ck!el(e• 'TCLI2 f Cri S J • Il RE: i Tcf-t,t# , T12AD-SS- 19 ' COMMENTS: I CA 11/1P- -The r(C April.Q i S-1- Gloi V �� 1 © f I-I-f i. ( o IA airs i . 2--./.. d il- lg., 4 D --• 1I, • M er "e/L,1-11i .S Q,c °( Seen rule.r s,ea_k h6, •.C . 1, UV 1 6t)49ecOf- pernos — hofi `'gut ? a pit f) It T161MGALLATIGN,TaTAlnm NT=/AQami,ms.an ATmwnrrr,vasemum rnmmainucaomumx 04111(009 001.0101.01116 liwi �wocam� TeieooVow oissou nirmmononree.amsexaerutorviewmoo=o ntoscowtwus.cono moo, .601144,410( k : m7.01a0yBTWOSISIL 0®�TnSr M131.0 LISOIONW WM oa1GWe6A4, . S, O TUE aWDGATlB6AWVL MMUS VIA Tis Il.a o OLS Om.000Yaea Suomi IL W,dmbs GnnWM1bau Oetm d 4emelFeer 044144WVJ40m0404.0 OIL�reaawLa0v14•ee 4an.Fl 4vmaxMv , LW.,v>rtrC a.m."F d haled 11.0044 m h Lod,=Lam Wart;b Ae peps..dw'LmO), t,0ea wev wmao.mr a ma.rw w e002meo a.,aa edseed,am • � Z t 1 S • SLawrence Eric Davidow D DS Harry A Davidow Lawrence A Siegel (1890-1954) Steven H Stem* Retired Michelle Jablonsky DAVIDOW, DAVIDOW, SIEGEL & STERN, LLP Wallace F Davidow Sanford L Davidow Regina E MacKay Counselors at Law•Original Firm Founded 1913 Martin S Glass Oded Ben-Ann Nassau Office One Suffolk Square•Suite 330 • 1601 Veterans Memorial Highway•Islandia,New York 11749 666 Old Country Road Of Counsel Tel(631) 234-3030•Fax (631)234-3140 Suite 810 Gina Raio Bitsimis Website: www.davidowlaw.com Garden City,NY 11530 Anne-Marie Monahan Tel(516)393-0222 Robert E Pipia Fax(516)228-6672 *Admitted to Florida Bar East End Office September 20, 2007 PO Box M344 Road Mattituck,NY 11952 Tel(631)298-9600 Town of Southold Fax(631)761-0370 Southhold Town Zoning Board of Appeals [..;Th.` Town Hall Annex Building - 54375 Route 25 PO Box 1179 OCT 1 5 2007 Southold,New York 11971 4tolpci;F Re: Lot Waiver Application y ` Location of Property: 10650 Sound Avenue,Mattituck, New York Dear Sir or Madam: Enclosed please find the following documents with respect to the lot waiver application: 1. Notice of Disapproval: Attached please find a Notice of Disapproval dated March 8, 2007 renewed on Sepiember 6, 2007. - - - 2. Application with following documents attached: a. Applicant Transactional Disclosure Form; b. Lot Waiver Questionnaire; c. Copies of recent tax bills for both lots; d. Copies of deeds dated prior to June 30, 1983 for both lots; e. Copies of current deeds of the parcels under review f. Copy of the current County Tax,Map for the neighborhood g. $150 dollar application check; h. Copy of Death Certificate for Charles R. Coutts (date of death 5/8/96). 3. Raised Seal Full Scale Surveys for both parcels. 4. Single and Separate Search with copy of Death Certificate for Charles R. Coutts (date of death 5/8/96). 5. Copies of following deeds: For Parcel Located at 142.00-01.00-003.003 (known as 1570 Factory Avenue, Mattituck, NY) a. Deed dated May 3, 1940; b. Deed dated July 27, 2006. i 1111 For Parcel Located at 142.00-01.00-003.002 (known as 10650 Sound Avenue, Mattituck, NY) a. Deed dated October 30, 1973; b. Deed dated July 27, 2006. 6. ZBA Questionnaire. 7. Town of Southold Property Record Card for both parcels. Very truly yours, DAVIDOW,DAVIDOW,SIEGEL&STERN,LLP Michelle Ja onsky OCT I 5 2007 ih-....reaLIM North FOrkEi:ik a division'of Capital One; N.A. MATTITUCK NOTICE: See Reverse side For Information: (877)694-9111 for Important Information 1-14-08 PAGE 1 FRANCES• J COUTTS FAMILY TRUST 042 GEOFFREY R HALLENBECK III TTEE , 2700 CAMP MINEOLA RD MATTITUCK NY 11952-2160 MORE BRANCHES,, MORE ATMS, MORE HOURS, MORE LOCATIONS, MORE WAYS TO SERVE YOU BETTER. FOR A WIDE RANGE OF PRODUCTS TO BETTER SERVE YOUR FINANCIAL NEEDS CALF OUR TELEPHONE EXPRESS BANKING CENTER AT 877-694-9111. SINCERELY FREE CHECKING 422606 632 4 Previous Balance 12-12-07 2,170.91 +Deposits/Credits 1 820.00 -Checks/Debits 7 1,364.86 -Service Charge .00 Ending Balance 1-14-08 1,626.05 Days in Statement Period 33 DATE DESCRIPTION CHECK# DEBITS CREDITS BALANCE Beginning Balance 2,170.91 12-18 , 117 355.98 1,814.93 12-18 118 337.88 1,477.05 12-20 119 !" 566.00 911.05 12-31 120 40.00 871.05 1-02 121 25.00 846.05 1-03 DEPOSIT 820.00 1,666.05 1-10 123 ' 15.00 1,651.05 1-11 122 25.00 1,626.05 Ending Balance 1,626.05 CHECKS. PAID DURING STATEMENT PERIOD F-• s * INDICATES CHECK OUT OF SEQUENCE NUMBER DATE AMOUNT NUMBER DATE AMOUNT 117 12-18 355198 118 12-18 337.88 l� - 119 12-20 •' ,566,00",'�;'' 120 12-31 40.00 •121 ,1-02, 25.100, 122 1-11 25.00 123 ' 1-10 • • END OF STATEMENT - .. North Fork Lnk a division of Capital One, N.A. MATTITUCK NOTICE: See Reverse side For Information: (877) 694-9111 for Important Information 1-14-08 PAGE 1 _ FRANCES MUTTS 042 OR GEOFFREY HALLENBECK III FACTORY AVE BOX 746 MATTITUCK NY 11952 MORE BRANCHES, MORE ATMS, MORE HOURS, MORE LOCATIONS, MORE WAYS TO SERVE YOU BETTER. FOR A WIDE RANGE OF PRODUCTS TO BETTER SERVE YOUR FINANCIAL NEEDS CALL OUR TELEPHONE EXPRESS BANKING CENTER AT 877-694-9111. SINCERELY FREE CHECKING 422600 086 9 Previous Balance 12-12-07 515.67 +Deposits/Credits .00 -Checks/Debits .00 -Service Charge .00 Ending Balance 1-14-08 515.67 Days in Statement Period 33 • • • • • END OF STATEMENT , „puke ' BY THE CCENTER FOR NURSING AND REHABILITATION HALLENBECK, GEOFFREY STATEMENT DATE: 1-01-08 2700 CAMP MINEOLA • RESIDENT NAME: COUTTS, FRANCES MATTITUCK . NY 11952 RESIDENT NUMBER: 001908 AMOUNT DUE: 60677 .74 OPENING BALANCE 39450 .18 12-09-07 ROOM & BOARD 2 9® 318.00 2862 .00 12-16-07 ROOM & BOARD 2 7@ 318.00 2226 .00 12-23-07 ROOM & BOARD 2 7@ 318 .00 2226 .00 12-31-07 ROOM & BOARD 2 8@ 318.00 2544 .00 12-01-07 591.48 1-01-08 ROOM CHARGE 31@ 328.00 10168 .00 1-02-08 SEMI-PRVT TAX ASSESS 610 .08 60677 .74 0.00 AMOUNT DUE: 60677 .74 61700 ROUTE 48,P.O. BOX 2122,GREENPORT, N.Y. 11944 (631)477-2110 Fax(631)477-8969 www.sansirneonbythesound.org A * ♦ , _ 11 T,t tItP STATEMEN -OF ACCOUNT SHORE PHARMACEUTICS___ _°DVIDERS,INC. 55 WEST AMES CT. �� � PPAGE: 1 of 1 PLAINVIEW,NY 11803 , -ACCOUNT NO: 40124 • "� INVOICE NO: PH512385 RETURN SERVICE REQUESTED - 30978 ` e.• r -DX NO: PLADX • ..m...1.- cool - . INVOICE DATE: 12/31/07 , • FACILITY: 94 SAN SIMEON NH PHONE: 516-938-8080 PATIENT NO: 1908 PATIENT NAME: COUTTS, FRANCES ' AMOUNT DUE: 8159.65 TAX: 0.00 IIIIIItIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII ' FRANCES COUTTS CIO GEOFFERY HALLENBECK DUE DATE: 01/30/2008 2700 CAMP MINEOLA RD ' . , , • . MATTITUCK, NY 11952-2160 ' - _ AMOUNT DUE: 8159.65 30978•T9W09SQXC000121 29 W09 WOZL:1.1 KEEP TOP PORTION FOR YOUR RECORDS-RETURN BOTTOM STUB WITH PAYMENT IIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIII�IIIII�IIIIIIIIIIInINIIIIiIIIIIIIIIIIII FACILITY COUTTS, FRANCES 94 SAN SIMEON NH ACCOUNT NUMBER INVOICE DATE 4012412/31/07 is ir'{h.o>''.r,.(:gyp rt v —Af,1`` ,l.-_«'"i„ I .- - - ..a •,. t.:. - - .' .._ , - - -. t<-. .; 11, .,; ,;".4,,p,`t�,,� :,s ;'. 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' •ICkES:",�-' 00143-1248=:10, =5f ,a ` =11.t35, Itk,_ 60;441415'h12589 $7 fR T11izN �0;..v. . li.'• ;��,r,:t -- ..t.��K ' -,>-" :? l!, e .fCkES. 00143=1248-10` =30': ,' -2410 RX, :;i--", '812589487.R�fUi�N�' � - �;':; `:Y� 5 i �:<3��'wa.�4�,`k�;,• i e. �:��� �,,{ , ;12'///�06/j0T R13052593iCFIf1RG ) 1 ;ICKES' ' .00781-7112-55;e,,- :,,r:;'10., ',,,1,;,:17,,4;42 RX5 sy ; 1 12,0 ;1k'f3073210�CNARGE., ' 7)r`c4F ICkES' c00d93 ',,rp., i¢;-z. :700:04' 'RX;"r' . � �";� : 7176=10�=� 90' ... - , i2/17/97' R130h3988 CNA1GE=,' , %r �;r" -ct •ICkES • ' 0458-0301-50 • `60. 212:73 RX I2/1f/07';,R13093042,d-IARC ;r. ; ,, • . :)�, :I, ,tax ckEs 00093-7177-10 ;'3 ,.,p r; . ,6+72 RX �',,s$�Q.40 •', '7',126 RX. ' • 12%.1�/0T E1,144320 CIiARGE ,1 '` " f.'.CKES 00781'-•'1(78-10; ;' "'30' ', .''I' 12/30/07 R12636394 CHARGE.' ' • . _ - .... .--_- 1.4 ICkES, , 00527-1443-01 30 12.28 RX 12/31/07 R13149207 c1iARGE IcKES 00093-7175-56 30 37.47 RX A' W '' �5 ` * ICKES 50458-0302 50 75 290.52 RX 12/31/07 R13149206 CHARGE - • ' i ', fl, '`f3, Messages ' FINANCE CHARGES are calculated at a MONTHLY PERIODIC RATE OF 1.50%(ANNUAL RATE OF 18.00%)based upon an unpaid balance ' outstanding 30 days or more. PREVIOUS BALANCE CHARGES FINANCE CHARGE TOTAL CHARGES PAYMENTS & CREDITS AMOUNT DUE 7319.86 839.79 . ' ' 0.00 8159.65 0.00 8159.65 F— 30978`T9W09SQXC000121 TO INSURE PROPER CREDIT,DETACH AND RETURN THIS PORTION IN THE ENCLOSED ENVELOPE. 5202348 ❑Please check if above address is incorrect and indicate change on reverse side., IF PAYING BY MASTERCARD,DISCOVER,VISA OR AMERICAN EXPRESS,FILL OUT BELOW. CHECK CARD USING FOR PAYMENT ACCOUNT NO: 40124 M., "l•1. (] ®� >,�� .'';'r sr_ INVOICE NO: PH512385 -' L. A MASTERCARD DISCOVER VISA AMERICAN EXPRESS DX NO: PLADX - CARD NUMBER SIGNATURE CODE INVOICE DATE: 12/31/07 , FACILITY: 94 SAN SIMEON NH - SIGNATURE EXP.DATE PATIENT NO: 1908 - ' PATIENT NAME: COUTTS, FRANCES ,' - MAKE CHECK PAYABLE&REMIT TO: AMOUNT DUE: 8159.65 '. IIInIiI11111111111I IlIII111u111111llnullllIlIIIIIfIII1III ' • ' SHORE PHARMACEUTICAL PROVIDERS , i AMOUNT ENCLOSED $ P.O. BOX 740391 - �'CINCINNATI, OH 45274-0391 ' 0000000040124000PH5123855000PLAD�(2000.8159652 ZBA TO TOWN CLERK TRANSMITTAL SHEET (Filing of Application and Check for Processing) DATE: 10/ 16 /07 ZBA# NAME CHECK # AMOUNT TC DATE STAMP RECEIVED 6098 Geoffrey Hallenbeck as Trustee of F. Coutts 107 $150.00 OCT 1 7 2007 Family Trust SCUtil Tow21 Clams $150.00 By Thank you. Lawrence Eric Davidow II)IJDSS Harry A Davidow Lawrence A Siegel (1890-1954) Steven H.Sterns Reared Michelle Jablonsky DAVIDOW, DAVIDOW, SIEGEL & STERN, LLP Sanford L Davidow Regina E.MacKay Counselors at Law•Original Firm Founded 1913 Martin S Glass Oded Ben-Ami Nassau Office .. One Suffolk Square• Suite 330• 1601 Veterans Memorial Highway•Islandia,New York 11749 666 Old Country Road Of Counsel Tel (631)234-3030 •Fax(631) 234-3140 Suite 810 Gina Raio Bitsimis Garden City,NY 11530 Anne-Marie Monahan Website: www.davidowlaw.com Tel(516)393-0222 Robert E Pipia Fax(516)228-6672 *Admitted to Florida Bar East End Office q= 'l 13105 Main Road PO Box 344 October 8 2007 Mattituck,NY 11952 Tel(631)298-9600 OCT1 5 2007 Fax(631)761-0370 Mr. Geoffrey R. Hallenbeck, III 2700 Camp Mineola Road V Mattituck,New York 11952 Re: Frances J. Coutts Dear Geoff: Enclosed please find seven(7) copies of the documents the town requires for submission with the application to waive the merger of the properties. The top copy is the original set(your check is also ' attached to the top copy). - I have attempted to submit these documents three times in the past month. However, each time I attempt to submit the documents, I am advised by Linda Kowalski that additional information is necessary. On my last try, I was advised that to Town required a title search back to 1957. I just received the new (revised) search from the title company today. Unfortunately I have no alternative but to send these documents to you to submit to the town as I am scheduled to have my second child this week. As I do not want to delay these proceedings any longer than necessary, as indicated above, I am providing you with these documents so that you can submit them to the town as soon as possible. I am expected to be out of the-office for about 6-8 weeks. However, if you have questions during the period of time while I am out,please contact Barbara Wolford or Sylvia Grenci and relay your message to them. I will get back to you upon receipt of your message as soon as possible. I am sorry for any inconvenience this may cause you. Very truly yours, DAVIDOW,DAVIDOW,SIEGEL&STERN,LLP Michelle Jablonsky i,ig oFF014- = Office Location: �e \O Co Mailing Address: ► � yam: Town Annex/First Floor,North Fork Bank y $ 53095 Main Road 54375 Main Road(at Youngs Avenue) 0 Pr7 ,, P.O. Box 1179 Southold,NY 11971 L, 40- e Southold,NY 11971-0959 iNg *'„106 http://southoldtown.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631)765-1809 Fax (631) 765-9064 FACSIMILE TRANSMITTAL SHEET /atustie:t:), TO: Fax# 171 L9/Via Date: TOTAL NO. OF PAGES INCLUDING COVER: z /i /4-5- SENDER'S TELEPHONE NUMBER: 765-1809 (press 1 at voice recording) REFERENCE:: ❑URGENT 0 FOR YOUR UPDATE 0 PLEASE COMMENT 0 AS REQUESTED 0 NOTES/COMMENTS: Please find attached copy/copies of the following: Z-44-)(0P-0-61; G L 7 f 2- t ) ' /_ ati.47-5 ;_xxiy 272etz, 0P7.---„ze&st, 7Y Thank you. Sender's Initials: )Le.iao41-1-744r y?p Sam.-t,(e r - -`�' • a avuet (IV j .1-1-4A19 !/l Ci � S��_1�( �- FORM NO. 3 b-„_;n u m CLQ ,9± N ps c7 n..3: Z TOWN OF SOUTHOLD � 3,fio ` BUILDING DEPARTMENT (Y i ya,/ � SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL Date: March 8, 2007 TO: Geoffrey Hallenbeck Trustee of F Coutts Family Trust 2700 Camp Mineola Rd. Mattituck, NY 11952 Please take notice that your application dated February 23, 2007 For a permit for merger determination at Location of property 10650 Sound Ave., Mattituck,NY County Tax Map No. 1000—Section 142 Block 1 Lot 3_2 Is returned herewith and disapproved on the following grounds: The subject lot has merged with an adjacent lot SCTM#1000-142-1-3.3 pursuant to Article II, Section 28040(A)which states: "Merger. A nonconforming lot shall merge with an adjacent conforming or nonconforming lot which has been held in common ownership with the first lot at any time after July 1, 1983. An adjacent lot is one which abuts with parcel for a common course of fifty(50) feet or more in distance. Nonconforming lots shall merge until the total lot size conforms to the current bulk schedule requirements." 624 Authorized Signature `, `iti_. riL , dnn /,L� THOIVi:d R. MERCIER, M.D., F.A.A.P. 0(''21PIP. ( 1045 LOVE LANE �p-cj, 1 P.O. BOX 1423 J MATTITUCK, NY 11952 FELLOW TELEPHONE 631-298-5454 AMERICAN ACADEMY OF PEDIATRICS (�((��pppp////(� FAx 631-298-5452 RECEIVED November 23,2007 James Dinizio,Jr., Chairman NOV a 8 int Zoning Board of Appeals s int/ O L Qf Town of Southold BOARD OF APPEALS P. O. Box 1179 Southold,NY 11971 Re: Francis J. Coutts Family Trust by Geoffrey Hallenbeck,III,Trustee, #6098 Dear Mr. Dinizio: We own the property at 10530 Sound Avenue(southwest corner of Sound avenue and Factory Avenue),which faces the Coutts property. We fully support Geoffrey Hallenbeck in his appeal to unmerge the two lots and we urge the Zoning Board of Appeals the grant this waiver. Sincerely, PQM/0 "Illeke.kM0 Thomas R. Mercier,MD Barbara Mercier cc: Davidow,Davidow, Siegel,& Stem,LLP Geoffrey Hallenbeck III Lawrence Eric Davidow kDS Han,A Davidow Lawrence A Siegel - (1890-1954) Steven H Stern* DAVIDOW, Michelle Jablonsky DAVIDOW, DA'V IDOW, SIEGEL & STERN, LL.0�] Wallace F Davidow Regina E MacKaySanford L Davidow Re g Counselors at Law•Original Firm Founded 1913 Martin S Glass Oded Ben-Ami Nassau Office One Suffolk Square• Suite 330• 1601 Veterans Memorial Highway•Islandia,New York 11749 666 Old Country Road Of Counsel Tel (631)234-3030 •Fax(631)234-3140 Suite 810 Gina Raio Bitsimis Website: www.davidowlaw.com Garden City,NY 11530 Anne-Mane Monahan Tel(516)393-0222 Robert E Pipia Fax(516)228-6672 *Admitted to Florida Bar -- East End Office t� 13105 Main Road D-c-.mb� w;. '3s9 PO Box 344 Mathtuck,NY 11952 Tel(631)298-9600 d=;- Fax(631)761-0370 Town of Southold -, Southhold Town Zoning Board of Appeals Town Hall Annex Building * 53095 Main Road '��%�=t;►4y �r �� -- '=" J PO Box 1179 Southold, New York 11971-0959 - Re: Francis J. Coutts Family Trust by Geoffrey Hallenbeck III, Trustee#6098 Location of Property: 10650 Sound Avenue, Mattituck, New York Dear Sir or Madam: Enclosed please find the following documents with respect to the above referenced matter: 1. One (1)White Receipt Postmarked for second attempt of mailing notice to property owner as well as green signature for unclaimed mail for first attempt of mailing 2. Five`(5) Green Signature Cards received for mailings. Very truly yours, DAVIDOW,DAVIDOW,SIEGEL&STERN,LLP _ 4 A t idcy7 Michelle Jablonsky MJ/smg ZONING BOARD OF APPEAL' MAILING ADDRESS and PLACE OF HEARINGS: 53095 Main Road, Town Hall Building, P.O. Box 1179 Southold, NY 11971-0959 (631) 765-1809 Fax 765-9064 LOCATION OF ZBA OFFICE: Town Hall Annex at North Fork Bank Building, 1st Floor 54375 Main Road and Youngs Avenue, Southold website: http://southtown.northfork.net November 19, 2007 Re: Town Code Chapter 55 — Public Notices for Thursday, December 20, 2007 Hearing Dear Sir or Madam: Please find enclosed a copy of the Legal Notice describing your recent application. The Notice will be published in the next issue of the Times Review newspaper. 1) Before November 27th: Please send the enclosed Legal Notice, with both a Cover Letter including your telephone number and a copy of your Survey or Site Plan (filed with this application) which shows the new construction area or other request, by CERTIFIED MAIL, RETURN RECEIPT REQUESTED, to all owners of property (tax map with property numbers enclosed), vacant or improved, which abuts and any property which is across from any public or private street. Use the current owner name and addresses shown on the assessment rolls maintained by the Town Assessors' Office located at Southold Town Hall, or Real Property Office at the County Center, Riverhead. If you know of another address for a neighbor, you may want to send the notice to that address as well. If any letter is returned to you undeliverable, you are requested to make other attempts to obtain a mailing address or to deliver the letter to the current owner, to the best of your ability, and to confirm how arrangements were made in either a written statement, or during the hearing, providing the returned letter to us as soon as possible; AND not later than November 28th: please either mail or deliver to our office your Affidavit of Mailing (form enclosed) with parcel numbers, names and addresses noted, and furnish it to our office with the white receipts postmarked by the Post Office. When the green signature cards are returned to you by the Post Office, please mail or deliver them to us before the scheduled hearing. If any signature card is not returned, please advise the Board during the hearing and provide the card (when available). These will be kept in the permanent record as proof of all Notices. 2) Not Later December 10th: please make arrangements to place the enclosed Poster on a signboard such as cardboard, plywood or other material, posting it at your property for seven (7) days (or more) until the hearing is held. Securely place the sign on your property facing the street, no more than 10 feet from the front property line bordering the street. If you border more than one street or roadway, an extra sign is available for the additional front yard. Please deliver your Affidavit of Posting prior to December 20. If you are not able to meet the deadlines stated in this letter, please contact us promptly. Thank you for your cooperation. Very truly yours, Zoning Appeals Board and Staff Encls. Office Location: //1,O�OSVFFOL�CO USPS Mailing Address: Town Annex/First Floor,North Fork Bank '� < 53095 Main Road 54375 Main Road(at Youngs Avenue) y Z P.O. Box 1179 Southold,NY 11971 %.‘"%'41 Oy �4,�$ Southold, NY 11971-0959 http://southoldtown,northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631)765-1809 Fax(631) 765-9064 FACSIMILE TRANSMITTAL SHEET iluteutacTo: From: Zoning Board of Appeals Date: Novemberp;2007 9f2-0' /7 q0MPANY: TOTAL NO.OF PAGES INCLUDING COVER: /' SENDER'S TELEPHONE NUMBER: 3'`/ —3 i. 765-1809(press 1 at voice recording) Re: Public Hearing December 20,2007 REFERENCE: 609g' 0 URGENT 0 FOR YOUR UPDATE 0 PLEASE COMMENT 0 AS REQUESTED 0 NOTES/COMMENTS: Please find attached copy/copies of the following: Legal Notice,tax map,cover letter. Sign and affidavits to follow by mail Thank you. Sender's Initials: i& TkE 61' HERRIA, "he following application will be heard by the Southold Town Board of Appeals at Town Hall, 53095 Main Road, Southold: FAME : HALLENBECK, Trustee #6098 IIAP # : 142- 1 -3 .2 & 3 . 3 APPEAL : Waiver of Lot Merger FEQUEST: Undersized Lots DATE : THURSDAY, Dec . 20 , 2 :20 PM If you are interested in this project, you may review the file(s) prior to the hearing during normal business days between 8 AM and 3 PM . 1ONING BOARD-TOWN OF SOUTHOLD 765- 1809