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Home My WebLink About1000-126.-4-17.2 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Leslie Weisman, Chair Members of the Zoning Board of Appeals From: Mark Terry, Principal Planner LWRP Coordinator Date June 30, 2011 Re: Coastal Consistency Review for ZBA File Ref. JAMES and JANET D'ADDARIO #6481 SCTM#1000-126-4-17.2 JAMES and JANET D'ADDARIO ~o481 - Request for Variance from Code Section 280-123 and the Building Inspector's May 19, 2011 Notice of Disapproval based on an application for building permit for additions/alterations to a non-conforming building at; 1 ) a nonconforming building containing a nonconforming use shall not be enlarged unless the use of such building is changed to a conforming use, Location: 18905 Peconic Bay Blvd., Laurel, NY. SCTM#1000-126-4-17.2 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is CONSISTENT with the LWRP policy standards and therefore CONSISTENT with the LWRP provided .that the Board requires the following: Show the relocation of the upgraded sanitary system greater than 100' from the wetlands, drywells for storm water control and hay bale line as referenced in the response to Policy 5. on the Coastal Consistency Assessment Form on the plans. Pursuant to Chapter 268, the Southold Town Zoning Board of Appeals shall consider this recommendation in preparing its wdtten determination regarding the consistency of the proposed action. Cc: Jennifer Andaloro, Assistant Town Attorney Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III- Policies Pages 32 through 34 for evaluation criteria. ~ Yes ~ No [] Not Applicable The project will neither affect nor have an impact on air quality in the Town of Southold. Policy 7 is not applicable to the project. Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section 1II - Policies; Pages 34 through 38 for evaluation criteria. [] Yes [] No ~ Not Applicable The project will neither create nor require the handling of solid waste or hazardous substances. Policy 8 is not applicable to the project. PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section I11 - Policies; Pages 38 through 46 for evaluation criteria. ~ Y~ No ~ Not Applicable The project is limited to the upland portion of the property, public access and recreational use of the adjacent coastal waters and public lands and resources will not be affected by the project. Policy 9 is not applicable to the project. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section !11 - Policies; Pages 47 through 56 for evaluation criteria. [] Yes ~--~ No [] Not Applicable The project neither proposes nor affects water dependent uses. Policy 10 is not applicable to the project. Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. [] Yes [] No ~ Not Applicable The project neither proposes nor affects commercial or recreational fisheries or other uses associated with living marine resources of Long Island Sound. Policy 11 is not applicable to the project. Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III- Policies; Pages 62 through 65 for evaluation criteria. [] Yes [] No ~ Not Applicable The proiect site is neither situated on nor adjacent to agricultural lands. Policy 12 is not applicable to the project. Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section Ill - Policies; Pages 65 through 68 for evaluation criteria. [] Yes ~ No [] Not Applicable The project affects neither the use nor development of energy and mineral resources. Policy 13 is not applicable to the project. Created on 5/25/05 11:20 AM Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. ~Yes ~] No[-~ (Not Applicable - please explain) The project neither proposes nor affects water-dependent uses. Policy 10 is not applicable to the project. Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section Ill - Policies; Pages 57 through 62 for evaluation criteria. ~ Yes ~ No ~ Not Applicable - please explain The project neither proposes nor affects commercial or recreational fishedes or other uses associated with the living madne resources of Long Island Sound. Policy 11 is not applicable to the project. Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section Ill - Policies; Pages 62 through 65 for evaluation criteria. ~Yes ~ No~'~ Not Applicable- please explain The project site is neither situated on nor adjacent to agricultural lands. Policy 12 is not applicable to the project. Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ~ Yes ~-~ No ~ Not Applicable - please explain The project affects neither the use nor development of energy and mineral resources. Policy 13 is not applicable to the project. Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III- Policies Pages 6 through 7 for evaluation criteria [~ Yes [] No [] Not Applicable To the extent that this policy is applicable to the proposed project, visual quality and scenic resources will be protected at the site through the protection and maintenance of the well vegetated area buffering the developed portion of the site from the tidal wetlands of Hortons Creek. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria [] Yes [] No ~] Not Applicable The project does not address nor affect erosion control structures or other erosion / flooding control initiatives. Policy 4 is not applicable to the project. Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria Yes [] No [[--]Not Applicable The proposed proiect is consistent with Policy 5 via (3) major proiect components; 1 - upgrade and relocation of the existing septic system more than 100 feet from the wetlands to ensure effective treatinent of sanitary waste; 2 - installation of a drainage system of drywells to control, manage and recharge storm water runoff; and 3 - retention of the existing vegetation on the northerly portion of the site to be protected from the site disturbance during construction by a project- limiting fence and staked haybales. Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes [] No [] Not Applicable This project will be consistent with Policy 6 for the same reasons described for Policy 5; because there will be no loss of wetlands and because the statutory and regulatory requirements of both the $outhold Town Trustees and the New York State Department Conservation will be complied with. BOARD MEMBERS Leslie Kanes Weisman, Chairperson James Dinizio, Jr. Gerard i~ Goehringer George Horning Ken Schneider S o u t h c l~d T~-o~//n~H a i~11' lo¢ 53095 Main Road · EO. Box 1179 Southold, NY 11971-0959 Office Location: Town Annex/First Floor, Capital One Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 http://southoldtown.north fork.net ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809 · Fax (631) 765-9064 June 15, 2011 Mark Terry, Principal Planner LWRP Coordinator Planning Board Office Town of Southold Town Hall Annex Southold, NY 11971 Re: ZBA File Ref. No. #6481 (D'Addario) dUN 1 5 2011 Dear Mr. Terry: We have received an application for additions and alterations to a nonconforming building in Laurel. A copy of the Building Inspector's Notice of Disapproval under Chapter 280 (Zoning Code), and survey map, project description form, are attached for your reference. Your written evaluation with recommendations for this proposal, as required under the Code procedures of LWRP Section 268-5D is requested within 30 days of receipt of this letter. Thank you. Very truly yours, Leslie K. Weisman Chairperson Encls. TO: Mark Schwartz for J & J D'Addario P O Box 933 Cutchogue, NY 11935 TOWN OF SOUTHOLD FORM NO. 3 NOTICE OF DISAPPROVAL DATE: 05/19/11 Please take notice that your application dated May 16, 2011 For permit for addition & alterations to a nonconforming building at Location of property: 18905 Peconic Bay Blvd., Laurel, NY County Tax Map No. 1000 - Section 126 Block 4 Lot 17.2 ls returned herewith and disapproved on the following grounds: The proposed construction in the R40 Zone is not permitted pursuant to Article XXIII Section 280-123 "A nonconforming building containing a nonconforming use shall not be enlarged, reconstructed or structurally altered or moved, except as set forth below, unless the use of such building is changed to a conforming use". Authorized Signature CC: file, ZBA. Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Building Department. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ,20 Approved ,20 Expiration ,20 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLISq Bui~i~&~!s~:ctor Do you have or need the following, before applying'. Board of Health 4 sets of Building Plans Planning Board approval Survey. Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Phone:~ 3 41J f APPLICATION FOR BUILDING PERMIT Date 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 n~t bbi¢ommenced 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 buildi.ng p.c4'mit ~b~l.1 expire if. the work. authorized has not commenced within 12 months after the date of l ssuange or has not been completed wif~h.fn .18 ~onths from such date. If no zoning q .mendments or other regulations affecting the property'h~v~ b~en ~nhcted in the interim, the Bui'td'ing Inspector may anthoriz~' iff ~vritin~', the extension of the permit for an addition six rnohthg.'Thereafter, a new permit shall be required. ' ' ' ' APPLICATION IS HEREBY MADE to the Building Department for t'n~ iss~hn~'e'of a; B~uiIding Permit pursuant to the Buikling Zone Ordinance of the Town of Southold, Suffolk County, 'New York, and other applicable Laws, Ordinances or Regulations, for the construcuon of buildings, additions, or aherations or for removal or demolition as herein described. The applicant agrees to comply with all applicable Iaws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for neeessary inspections. (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicani is owner, lessee, agen~ngineer, general contractor, electrician, plumber or builder Natqle of owner of premises (As on the tax roll or latest deed) It' applicant is a corporation, signature of duly authorized officer License.N~,~.~. :,, v ~ ~;. ,t ~ Builders Plmnbers License No. Electricians License No. Other Trade's License No. Location of'land on which proposed work will be done: House Number Street / County Tax Map No. 1000 Section ! ?-' ~' Block Subdivision Hamlet ~ <~ Lot tt 7, ~. Filed Map No. Lot b. Intended use and occupancy ~',Z) ~ ~ 3. Nature of work (check which applicable): New Buildi'ng Repair ~ Removal Demolition 4. Estimated Cost Fee se and occu ancv (,~ a. Existingu p . ' ~-~ J / Addition Other Work Alteration (Description) (To be paid on filing this application) If dwelling, number of dwelling units If garago,.nu~ber .of .cars Number of dwelling units on each floor 6. If business, commercial or mix. ed,qccupancy, specify nature aud 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 Depth Height Number of Stories 10. Date of Purchase t Dimensions of entire new construction: Front Height Number of Stories Size of lot: Front Rear Rear _Depth Depth Rear Name of Former Owner l 1. Zone or use district in which premises are situated ~i~ df- 12. Does proposed construction violate any zoning law, ordinance or regulation? YES I//NO . 13. Will lot be re-graded? YES NO ~/Will excess fill be removed from p. remises? YES 14, Names of Owner of premises ~ ~O~a~ Io Address Name of Architect ~C/'f'~,',~'~ '¢ Z. Address Name of Contractor O,4'~ ~. ! ~ c. £ ~' a,J Address NO ?honeNo. 5/~,~,~ ~'¢ /,,q"¢ Phone No "¢~ '¢ qCt'~¢'~-q~ Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a fl'eshwater wetland? *YES__ * 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. NO ,X 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. 18. Are there any covenants and restrictions with respect to this property? * YES · IF YES, PROVIDE A COPY. NO O~ STATE OF NEW YORK) SS: . . COUNTY OF J't//-"F6,f.,&...) "' ~ ff'~/ being duly sworn, deposes and says that Qh_e is. the.applicant (Name of individual signing contract) above named, (S)He is the ~..C.-/1/~ (Contractor, Agent, Corpora/re 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 perlbrmed in the manner set forth itt the application filed therewith. Sworn to before me this~N ,-,: . 2~('ht day°f,'h'x'~7/).~k,.~ 20 No[aw Public APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS Fee: $ Office Notes: __ Filed By:. For Office Use Only Date Assigned/Assignment No. House No. 8905 Street Peconic Bay Boulavard Hamlet Laurel SCTM 1000 Section 126 Block 4 Lot(s) 17.2 Lot Size 49,637 sQ. ft. Zone R40 1 ONE) APPEAL~HE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED ,~//~/// BASED ON MAP DATED /o2//~f///~ Applicant(s)/Owner(s): lames and ~anet D'Addar~o MailingAddress: 45 Clock Tower Lane, Old Westburv, New York 11568 Telephone: (516) 455-2786 Fax #: Email: NOTE: in addition to the above, please complete below if application is signed by applicant's attorney, agent, architect, builder, contract vendee, etc. and name of person who agent represents: Name of Representative: Mark Schwartz, Architect for ~) Owner, or {~ Other: Agent's Address: P.O. Box 933, Cutchogue, Ny 11935 Telephone (631) 73~4185 Fax #: (631) 734-2110 Email: mksarchitect~optonline.net Please cheek box to specify who you wish correspondence to be mailed to, from the above names: [~Applicant/Owner(s), or [Z~Authorized Representative, or [~)ther Name/Address below: WHEREBY THE BUILDING IN_~S~ECTO~R REVIEWED MAP DATED/~-~2/////~t9 AN APPLICATION DATED ~5 / / q~ /// FOR: [~Building Permit / [~Certificate of Occupancy [~Pre-Certiflcate of Occupancy [~Change of Use [~Permit for As-Built Construction [~)ther: and DENIED Provision of the Zoning Ordinance Appealed. (Indicate Article, Section, Subsection of Zoning Ordinance by numbers. Do not ¢mot~the code.) article~X[/I Section 280-/;,~ ~ Subsection Type or, peal. An Appeal is made for: ~ Variance to the Zoning Code or Zoning Map. ~A Variance due to lack of access required by New York Town Law-Section 280-A. [~ nterpretation of the Town Code, Article Seclion ~Reversal or Other A prior appeaC~has, [~as not been made at any time with respect to this property~ UNDER Appeal No. l-~ Year__. (Please be sure to research before completing this question or call our office fi~r assistance.) Name of Owner: ZBA File # REASONS FOR APPEAL (additional sheets may be used with preparer's signature): AREA VARIANCE REASONS: (1) An undesirable change will not be produced in the CHARACTER of the neighborhood or a detriment to nearby properties if granted, because: An undesirable change will not be produced in character to the neighborhood or nearby properties because the character of the house is consistent with neighboring houses and is within allowable roof heights as required by the town (2) The benefit sought by the applicant CANNOT be achieved by some method feasible for the applicant to pursue, other than an area variance, because: The benefit sought cannot be achieved by method feasible because of use of occupancy. (3) The amount of relief requested is not substantial because: The amount of relief requested is not substantial because the proposed addition is within the allowable building envelope. (4) The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: The variance will not have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because the existing septic system will be removed and a new one installed. Drywells will also be installed to collect water runoff to reduce erosion. (5) Has the alleged difficulty been self-created? [~]Yes, or [~o. Are there Covenants and Restrictions concerning this land: [~]No. [~Yes (t, tease£urnish covv). This is the MINIMUM that is necessary and adequate, and at the same time preserve and protect the character of the neighborhood and the health; safety, and welfare of the community. Chech this box 0 IF A USE VARIANCE IS BEING REQUESTED, AND PLEASE COMPLETE THE ATTACHED USE VARL4NCE SHEET: (Please be sure~;)sult yo~a~)~ /~l nat~/e o~fA~nn~la~nnt/or Authori 'g - App~lantlor Authorized Agent (Agent must submit writl~q~ahorizafion from Owner) Swor~a~oefore me this Notary Public No. 01T08190596 Qualified in Suffo k County. ,-~ Cornmissio~ Expires JL~I~ ,"~ ?h/~ QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION ls the subject premises listed on the real estate market ~br sale? Yes _ i,/ No Are there any proposals to change or alter land contours? Yes please explain on attached sheet. 1.) Are there areas that contain sand or wetland grasses? FI c~ 2.) Are those areas shown on the survey submitted with this application? x/c?~) 3.) Is the property bulk headed between the wetlands area and the upland building area? F~ ~) 4.) lfyour property contains wetlands or pond areas, have you contacted the Office of the Town trustees for its determination ofjurisdic~tion? X/~-3 Please confirm status of your inquiry or application with the Trustees: .~¢.i)t)v¥,~dD~\t.--~' i~clA'C'JO[iFI ~' and if issued, please attach copies of permit with conditions a~d approved survey. ls there a depression or sloping elevation near the area of proposed construction at or below five feet above mean sea level? Are there any patios, concrete barriers, bulkheads or fences that exist that are not shown on the survey that you are submitting? (~ ~ Please show area of the structures on a diagram if any exist. Or state none on the above line. F. Do you have any construction taking place at this time concerning your premises? ~ ~9 If yes, please submit a copy of your building permit and survey as approved by the Building Department and please describe: Please attach all pre-certificates of occupancy and certificates of occupancy for the subject premises. If any are lacking, please apply to the Building Department to either obtain them or to obtain an Amended Notice of Disapproval. Do you or any co-owner also own other land adjoining or close to this parcel? G. If yes, please label the proximity of your lands on your survey. H. Please list present use or operations conducted at t ~ s parce cq ~ [l~ c~ + and the proposed use ,.">i).3h'~L- LU"t44,'x garage, pool ~>~ other) ' .~1 Authorized slgnatur~:[~te APPLICANT'S PROJECT DESCRIPTION (For ZBA Reference) Applicant: James and Janet D'Addario Date Prepared: March 03,2010 1. For Demolition of Existing Building Areas Please describe areas being removed: front bump out wall on left side of house IL New Construction Areas (New Dwelling or New Additions/Extensions): Dimensions of first floor extension: overall: 14'~" x 19'-1/2" Left extension + 13'0 1/2" x 4'-6" Front Dimensions of new second floor: none Dimensions of floor above second level: none Height (from finished ground to top of ridge): highest point: 13'-9" Is basement or lowest floor area being constructed? If yes, please provide height (above ground) measured from natural existing grade to first floor: no III. Proposed Construction Description (Alterations or Structural Changes) (attach extra sheel if necessary) - Please describe building areas: Number of Floors and General Characteristics BEFORE Alterations: 1 story, 2 bedroom, 1 bath, kitchen, dining / living room, enclosed porch Number of Floors and Changes WITH Alterations: 1 story, 2 bedroom, 2 bath, new den, building, kitchen, dining / living room, enclosed porch 1V. Calculations of building areas and lot coverage (from surveyor): Existing square footage of buildings on your property: living: 3216.5 sf, porch / deck: 1493.6 sf, shed: 49 sf Proposed Jncreaseofbuildingcoveragc: living: 3513.2 sf, porch / deck:1493.6 sf, shed:49sf Square footage of your lot: 49,637 sq. ft. Percentage of coverage of your lot by building area: total proposed / existing (5055.8 sO: 10.2% V. Purpose of New Construction: Proposed new construction is to construct new master bedroom and add master bath, reconstruct / expand existing bedroom to become den, upgrade and relocate existing septic system, install drainage system of drywells to control, manage stormwater runoff. VI. Please describe the laud contours (fiat, slope %, heavily wooded, marsh area, etc.) on your land and how it relates to the difficulty in meeting the code requirement(s): Overall property slopes at approximatly 2% +/- (highest at el. 16' to lowest at el. 8'). Property is grassey and not heavily wooded. No wetlands are on the property. The proposed addition is minimal on the property {0.6% lot coverage) and does not negativly affect surrounding properties. Please submit seven (7) photos, labeled to show different angles of yard areas after staking corners for new construction), and photos of building area to be altered with yard view. 7/2002; 2/2005; 1/2007 PROJECT I.D. NUMBER 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only .PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEQR 6 DESCRIBE PROJECT BRIEFLY: 8. WILL P OPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? 10. D.~OT~ASTEACTi~L(~ANVL.~LVB A PERMIT APPROVAl OR ~LINDING, NO'W OR ULTIMATELY FROM~ ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, 11, DOES ANY ASP ~F THE A~ION HAVE A CURRE~LY V~D PERM~ OR AP~OVAL? 12. AS[_.~ yesA RESULT OF~NPoCE OPOSED ACTION WILL EXISTING PERMFrlAPPROVAL REQUIRE MODIFICATION? I CERTIP-Y THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BE-~T OF MY KNOWLEDGE I! the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER PART II--ENVIRONMENTAL ASSESSMENT (To be completed Dy Agency) D WILL THE PRQJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTAIBLtSHMENT OF A CEA? PART Ill--DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: Fo~ each adverse effect identified above, determine whether it is substantial, large, imporlant or otherwise significant. Each effect should be assessed in connection with its ia) setting (i.e. urban or rural}; (b) probability of occurring; (c) duration; ia) irreversibitity; (e) geographic scope; and if} magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail Io show that ail relevant adverse impacts have been identified and adequately addressed. I[ question D of Part II was checkecl '/es, the determination and significance must evaluate the potenti&l impact ol the proposed actio~ Check this box if you have identified one or more potentially large or significant adverse im'¢,acts which MAY occur. Then proceed directly to the. FULL EAF and/or prepare a positive declaratior~. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmentaJ impacts AND provide on attachments as necessary, the reasons supporting tl~is determination: Dale AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS TOWN OF SOUTHOLD WHEN TO USE THIS FORM: The form must be completed by' the applicant for any special use permit, site plan approval, use variance, or subdivision appraval on property within an agricultural district OR within 500 feet of a farm operation located in agricultural district. A I1 applications requiring an agricultural data statement must be referred to the Suffolk County Department of Planning in accordance with Sections 239- m and 239-n of the General Municipal Law. l) Name ofApplicant: ~Tt~Bq¢55 ..~..~'~dd(3~lc 2) AddressofApplicant: ~qC'5(~C~C~ i0~'Q:¥DC 3) Nmne of Land Owner (if other than applicant): 4) Address of Land Owner: 5) Description of Proposed Project: ~.~' ~ (5~ 6) Location of Prope~y (road and t~ map number) ~l~> 2) Is the p~rc~l within ~n ~ricultuml dJstrJct~ ~No ~Yes If yes, A~ricultuml District Number ls this p~rcel acfivel~ ~a~ed~ ~No ~Yes 8) 9) N~me m~d ~ddress of ~n~ owner(s) of land within operation(s) loomed 500 f~el of the bounds~ of the proposed project. (Informmion m~y be ~v~il~ble ~hrou~h lb~ Town Assessors Office, Town H~]I location (265-1932) or from any public compul~r at the Town Hall Ioc~fions by viewin~ the p~rcel numbers on lhe Town of Soulhold Re~J Proper~ T~x System. Natne and Address (Please use back side of page if more than six property owners are identified.) The lot numbers may be obtained, in advance, when requested from either the Office of the Planning Board at 765-1938 ortl~ Zoning Board o(-,A,m~eals at 765-1809. ./xx, "' '"Ir ~i~natttre of,~pplic~/ Date Note: I l'he I~cal board will solicit comments flora the owners o£ land identified above in order to consider the eflbc! of thc proposed action on thcir lhnn operation Solicitation will be made by suppl5 ing a copy of this statement. 2 Comments returned ~o the local board will be taken into consideration as part o£the overall review of this application. 3 Copies of thc completed Agricultural Data Statement shall be sent by applicant and/or the clerk of the board to thc property owners idenlilicd aboxe Iht cosl Jbr mailing shall be paid b> the applicam at the time the application is submitted for rcvicw. Failure to pa)' at such time means the application ~s not complete m~d cannot be acted upon by the board 1-14-09 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 126 _ 04 . 17.2 The Application has been submitted to (check appropriate response): Town Board [] Planning Dept. ~ Building Dept. [] Board of Trustees ~ Category, of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Proposed additions and alterations to existing one story cottage to expand living area. New drywells to collect roof runoff and new septic system is proposed. Location of action: 8905 Peconic Bay Boulevard, Laurel, NY Site acreage: 49,637 sq. ft. Present land use: 10.2% (total). (Proposed addition is 0.6%, Existing: 9.6%) Present zoning classification: R40 If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: James and Janet D'Addario (b) Mailing address: 45 Clock Tower Lane, Old Westbury, New York 11568 (c) Telephone number: Area Code ( ) (516) 455-2786 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ~ No [] lfyes, which' state or federal agency.9 DEC, Health dept., Bldg. dept. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section llI- Policies; Page 2 for evaluation criteria. ~Yes [] No [] Not Applicable The project entails additions and alterations to the exishng residenhal structure in a heavily developed neighborhood. Policy 1 is not applicable to the project. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section Ill - Policies Pages 3 through 6 for evaluation criteria [] Yes [] No ~ Not Applicable The subject property does not contain nor does the project affect historic or archeological resources; nor is the project located in a historic maritime area. Policy 2 is not applicable to the project. James and Janet D'Addario 45 Clock Tower Lane Old Wesfl)ury, New York 11568 516-626-9150 March 01,2011 To Whom It May Concern: We, James aud Janet D'Addario, authorize Mark Schwa(m, AIA - Architect, to act as agent tbr pemfit applications to the Southold Town Zoning board of Al)peals, Southold Town Board of Trustees, New York State Department of Em4ronmenm} Consen'ation; Suffolk Count3' Deparm~ent of Health and fl~e Southold Building Depamnent. Thc proposed residential constructiol~ project is located at 8905 Peconic Bay Boulevard, I2mrcl, New York (SCTM# 1000-1264)4-17.2). Sincerely, James and Janet D'Addario (late: APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Souffiold's Co(~ of Ethics prohibits conflicts of interest on the part of town officers and employees. The pm-pase of fids form is to ~x~vide informalion wirier can alert ~ tovm of ~o~sible conflicts of interest and allow it to take whateve~ action is necessar~ to avoid san~e. YOUR NAME: O'Addar[o, James & Janet (Last name, first name, middle initial, unless you a~e applying in the mtme of someone else or other entity, such as a company. If so, indicate the other' person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax gdevanee ~ I~uildlng ~ Variance Trustee Change of Zone Coastal Erc~ion Approval of plat __ Mo°nng Exemption from plat c~- official map planmng {If "Other", name the activity.) Do you per~nally (or through your company, spouse, sibling, parer/t, or child) have a relationslfip with any officer or employee of the Town of Southold? "Relaliomhip"includes by blood, mamage, or business interest. ~'Business interest" means a business. including a par'mership, in which the town officer or employee has even a partial ownership of (o~ employment by) a corporation in which the town officer or employee owns more than 5% of the shases If you answered "YE S", cornplete the balance of fi.is fom~ mxd date and sign where indicated. Name of pm-son employed by the Tovm of Southold Title or position of that person Describe the relatiortqhip between yourself(the applicant,'agent/representative) ,xnd the to~aa officer ox employee Either check the appropriate line A) through D) anctior describe in the space provided. The to~,m officer or employee or Ihs or her ~ouse, siNing, parent, or chld is (check all tlmt apply): [~ A) the owner ofg~eater than 5% of the :-.hares of the corporate stock of the applicant (whan the applicant is a corporation); F'] B) ire legal or beneficial owner of any nterest n a non-corporate entity Iwhen the applicant is not a corporation); ~_C) an officer, director, parmer, or employee of the applicant; or [.__kD) the acluat applicant. DESCRIPTION OF RELATIONSHIP Form ri S 1 APPLICANT TRANSACTIONAL DISCLOSURE FORM (FOR SUBMISSION BY OWNER andOWNER'S AGENT) The Town of Southold's Code of Ethics prohibits conflicts of interest on the part 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: Schwartz, Mark (Last name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person or company nmne.) NATURE OF APPLICATION: (Check Tax Grievance Variance Special Exception If"Other", name the activity: Change of Zone [ J Approval of PlatL J Exemption from Plat or Official Map I ] Other I 1 all that apply.) 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 interesf' 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 tbe Town officer or employee owns more than 5% of the shares. YEs[ ] NO L ¥ J Complete the balance of this form and date and sign below where indicated. Name of person employed by the Town of Southotd: Title or position of that person: Describe that relationship between ),ourself (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 appb'): [ ] A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); I ] B) the legal or beneficial owner of any interest in a non-corporate entity, (when the applicant is not a corporalion); [~-~ C) an officer, director, partner, or employee of the applicant; or [---'~ D) the actual applicant. DESCRIPTION OF RELATIONSHIP /~oo ~cr~.,~_]:~-,,~--,., OF SOUTHOLD PROPERTY RECORD CARD '-~,,~/~,~ ~.~ OWNER STREET ~'Ci ~)b VILLAGE DIST.SUB. /' ~o~ow.~ " ~ ~'- I ' ~. , S W TYPE OF BUILDING Tilbble 2 Woodl=nd Swomplond , FRONTAGE ON WATER Brushland FRONTAG~ ON ROAD House Plot, DEPTH ~ ~ "~ BULKH~D TOtal DOCK COLOR TRIM M. Bldg. ~ ~ I ~'~ 0 ~ ¥..~ Bath Extension ement I I Floors Extension Ext. Walls ~'A · Interior Finish Extension Fire Place Type Roof Rooms 1st Floor Porch ~ ~ I~'"' Recreation Rooms 2nd Floor Porch / Dormer Breezeway / Driyeway Garage /~/~ Patio ./' o.B.~ ~'X _ I J* Total "LOT OWNER STREET VILLAGE DIST.: SUB. FO~MEI~ O~NE~ ~' N ~ ACR. J I S W TYPE OF BUILDING RES. S~S. VL. FARM COMM, CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS AGE BUILDING CONDITION h ~ NOeL BELOW ABOVE F kRM Acre Value Per Value Acre Tillable 1 Tillable 2 Tillable 3 Woodlond Sw~mplond FRONTAG~ ON WAT[R ~ru~l~nd [RO~TAG~ O~ ROAD House ~lot DEPTH BULKH~D Total - COLOR TRIM Extension Extension Extension Porch Porch Breezeway Goroge Patio :tion Bath nent Floors Ext. Walls :::~"~ ~' c ~ Interior Finish Fire Place Heat Roof Rooms 1st Floor Room Rooms 2nd Floor Driveway Dinette ~-~/~ __1K. BR. FIN. B. ./,0~6- AOX- 4'7 '~""~ ~" "~'" .......... OWNER STREET VILLAGE DIST. SUB. ~- ~ E ACR. FORMER OWNER N r ~ES. ~ (~S~S. ~ VL. FARM cOMM. CB. MISC. Mkt. Value ~/ REMARKS ~/~- ~ND IMP. TOTAL DATE ~/~6b AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Ac re Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot DEPTH DOCK Total COLOR M. Bldg, ~ ~, '~..~ .~"~ F~ndetion .... ~. ~, 'x,~!: Bath /' Dinette Extension Extension Extension / ~ Fire Place ~/~ Heat ~ ~ DR. ~ .orc Porch ~z~w~y Garage Patio O.B. To,~, /~ q~ ,/ , IO~/3SNOH (]V3H)C1N8 I Extension ~ ~ ~ Basement Porch Dormer Fin B ~ ~ Rooms 1st Floor Breezeway /~,2T~WId rll: ~IITI.I(11_I~ DII~I)FSITY I~FCC~II[~ CARD /~,~TOWN OF SOUTHOLD OWNER Drr~.s x Jc~nc;t- b'Ad~cz~-G F_ORMER OWNER, STREET RES. 3// AGE SEAS. I PROPERTY RECORD CARD V l LLAGE W FARM COMM. CB. TOTAL REMARKS BUILDING CONDITION MICS. Mkt. DIST. SUB I _ I ACR.~ ~._ TYPE OF BUILDING ralue G L-IZ~I IN~lW IXlLtKMAL I BELOW ABOVE FARM Acre Value Per Value ' Acre Tillable FRONTAGE ON WATER Woodland J FRONTAGE ON ROAD House Plot BULKH~D Total DOCK TOWN OF $OUTHOLD PROPERTY RECORD CARD OWNER FORMER OWNER STREET S VILLAGE E W L ACR. TYPE OF BUILDING SEAS. Woodland LAN D IMP. TOTAL FARM 1~ DA, TE COMM. CB. MICS. Mkt. Value REMARKS AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Ac re Tillable FRONTAGE ON WATER FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total DOCK FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. EXISTING CERT~FI~ATEOFOCCUPAN~ No Z--26135 Date NOVEMBER 30, 1998 THIS CERTIFIES that the buildin~ DW~.I. INGS Location of Property 8905 GT. pECONIC BAY BLVD. LA~ House No. Street Hamlet County Tax Map%473880 Section 126 Block 4 Lot 17.1 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements ,for One Family Dwellings built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-26135 dated NOVEMBER 30, 1998 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is A~EA, ACCESSORY SHED, INGROUHD SWII~IING POOL & OOTTAGE-(ON LOT The certificate is issued to R/FAT TABI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTA~d~u INSPECTION REPORT. Rev. 1/81 N/A N/A N/A ~ //~/ding~nspector LOCATION: SUBDIVISION: NAME OF OWNER (S): RIFAT TABI OCCUp;kNCy: A-1REHIDE~IAL ADMI~'~ED BY: RIPAT TABI PORCH TYPE: DOMESTIC HOTWATER: 3ES # STORIES: 1.~ # EXITS: ~ CELLAR: PART CRAWL SPACE: PART 3RD FLR.: ~ UTILITY ROOM{S) : __ PATIO TYPE: ACCESSORY STRUC~S: C~GE, TYPE OF CONST.: ]~__ STORAOE, TYPE COMET.: ~ SWIllING POOL: INGROUND POOL GUEST, TYPE CONST.: YES-KITCHEN HEAT&BATH OTHER: *GARAGE HAS GUEST SLEEPING AREA (NO COOKING FACILITIES) ** ON P/O~LOT 31 _ FOR~ NO. 4 TOP~ OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED C~RTIFICATE OF OCCUPANCY No Z-26134 Date NOVEMBER 30, 1998 THIS CERTIFIES that the building DWELLING Location of Property. 8905 ~T. pECONIC BAY BLWD. House No. Street County Tax Map~473889 Section 126 Block 4 Subdivision A.L. DOWNS Filed Map No. 21 LA--L, N.Y. Hamlet Lot 17.1 Lot No.10 & 11 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 30, 1957 pursuant to which Building Permit No. 125 dated SEPTEMBER 30, 1957 was iseued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is The certificate is issued to RIFAT TABI ( owner ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A U~IDEI~WRITERS CERTIFICATE ~o. N/A PLUMBERS CERTIFICATION DATED N/A *TRIS UPDATES CO Z--121 DATED JTJNE 5, 1958 Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~qTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Ne: Z-27321 Date: 09/27/00 T~I$ C~TIFIES that the building ADDITION AND ALTERATION Locatlon of Property= 8905 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (HAMLET) ~ou~ty Tax Map No. 473889 Se~tlon 126 Block 4 Lot 17.1 Sub~ivleion Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 14, 1999 pursuant to which Building Pez~nit No. 25937-Z dated AUGUST 11, 1999 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued ie RENOVATE & ALTER EXISTING TWO FAMILY DWELLING TO A ONE FAMILY DWELLING & PORCN ADDITION AS APPLIED FOR. The certificate is issued to JAMES & JANET D'ADDARIO (O~ER) of the aforesaid building. SUF~OI,K ~ DEp]~I{TM~NT OF HK~O~I AP~OVAL ~C~ICAL (~qTIFICA~ NO. pL~K~s tu~KTIFI~ATION DATED 04/25/00 N520352 04/04/00 PEDNEAULT ASSOC., INC //Aut~r ized Signature Rev. 1/81 FORM NO. 4 TOW~ OF SOUTHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPD~NCY No: Z-28828 Date: 08/27/02 HIS C~TIFIES that the building ALTER3%TION I~)cation of l~ro~y: 8905 GREAT PECONIC BAY BL~qD IJkUREL (HOUSE NO.) (STREET) (}IAMLET) Collnty T~3~ ~p NO. 473889 Section 126 Block 4 Lot 17.1 S%~dlvlsion Filed Map NO. __ I~Dt NO. -- conforms substantially ko the Application for Building Permit heretofore filed in this office dated JULY 21, 2000 pursualat to which Building Permit No. 26795 Z dated SEPTEMBER 26, 2000 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is EXISTING G~d~AGE ~-LTERED TO A WORKSHOP/STOR3~GE BUILDING (NON-HABIT;LBLE). · ~ne certificate is issued to JD24ES & JA/~ET D'~DD~d~IO (OWNER) of the aforesaid building. ~/~u~ed Signature Rev. 1/8] FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPkRTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28829 Date: 08/27/02 T~IS CERTIFIES that the building ALTERATION Location of Property: 8905 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (}L~MLET) Cou/~ty Ta~ Map No. 473889 Section 126 Block 4 Lot 17.1 Subclivision Filed Map No. Lot NO. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 21, 2000 pursuant to which Building Permit No_ 26795 Z dated SEPTEMBER 26, 2000 was issued, and confor~s to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ALTERATION TO AN EXISTING GUEST COTTAGE AS APPLIED FOR. The certificate is issued to JANES & JANET D'ADDARIO (OWNER) of the aforesaid building. CERTIFICATION DATED 05/21/02 N/A 1070207 08/12/02 STEPHEN T KARRASS ~u~or'~ e~d ~i a ture Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPkNCY No: Z-28830 Date: 08/27/02 T~IS ~(TIFIES that the building ALTERATION Location of Property: 8905 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 126 Block 4 Lot 17.1 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore · iled in this office dated J]JLY 21, 2000 pursuant to which B~ilding Permit NO. 26795 Z dated SEPTEMBER 26, 2000 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ALTERATION TO AN EXISTING GUEST COTTAGE AS APPLIED FOR. T~e c~rtificate is issued to JA~4ES & JANET D'ADDARIO (OWNER) of the aforesaid building. N/A 1070207 08/12/02 05/21/02 STEPHEN T KARP~ASS ~/U~orized Signature Rev. 1/81 20.1 EXISTING FRONT ELEVATION EXISTING LEFT ELEVATION EXISTING REAR ELEVATION FRONT ELEVATION SCZLE; 1/8" = 1' LEFT ELEVATIO~ SCALE: ~/8" = ~' REAR ELEVATION SCALE: 1/8" = I' REVISIONS: m < A-1 BATH No 2 BEDROOM No 2 ExI~rlNG PORCH FLOOR PLAN SCALE: 1/8" = 1' I I _EXI'S'I-[NG FLOOR PLAN SCALE: 1/8" = 1' · REVISIONS: A-2 FLOOD ZONE FROM FIRM MAP NUMBER 36103C0461H SEPTEMBER 25, 2009 ELEVATIONS REFERENCED TO N.A. LOT NUMBERS REFER TO "MAP OF A.L. DOWNS" FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON AUGUST 14, 1929 AS MAP NUMBER 21. I om fomilior with the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES ond w#l ab/de by the conditions set forth therein ond on the permit to construct, The locotion of public *voter sho*vn hereon ore from field observotions ond or from doto obto¢hed from others, SURVEY OF PROPERTY A T LA UREL TO'tN OF SOUTHOLD SUFFOLK COUNT~, N.Y. 1000-126-04 -1 ~.2 SCALE: 1'--30 DECEMBER 14, 2010 v v v ~ ............ ~ ............ f ...................... ~.' (el D) S87'04'I0'E OF WA Y PlO LO~' 10 AREA-49,637 SO. FT. TEST HOLE DATA McDONALD GEOSCIENC£ ANY AL~RA770N OR ADDI770N TO THIS SURVEy IS A [40LA~70N OF SECTION 720£0F THE NEW YORK STATE EDUCA~70N LAM EXCEPT AS PER SEC~ON 7209-SUBD/~SION 2. ALL CER~FICA~ONS HEREON ARE VALID FOR ~lS MAP AND COPIES ~EREOF ONLY IF B=MONUMENT SAID MAP OR COPES DEAR ~ IMPRESSED SEAL OF ~E SUR~YOR I =~TLAND FLAG ~OSE SIGNA~RE APPEARS HEREON. 1 5 2011 LIC. NO. 49618 -5020 FAX (6J1) 765-1797 909 1230 TRAVELER STREET SOUTHOLD, J.× .97~ ~10-255