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HomeMy WebLinkAbout1000-21.-5-11 L/ OFFICE LOCATION: O~~QF SOUjyO MAILING ADDRESS: Town Hall Annex h ~ P.O. Box 1179 54375 State Route 25 ~ l~f Southold, NY 11971 (coc. Main Rd. & Youngs Ave.) H ~ Southold, NY 11971 G C Telephone: 631 765-1938 ~ Fax: 631765-3136 ~'~OOUN[`l,~ 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: August 28, 2013 Re: Coastal Consistency Review for ZBA File Ref. FORDHAM HOUSE. LLC #6880 SCTM#1000-21-5-11 FORDHAM HOUSE LLC #6680 -Request for Variances from Article IV Code Section 280-18 and Article XXII Code Section 280-116 based on an application for building permit and the Building Inspector's July 24, 2013, amended August 6, 2013 Notice of Disapproval concerning a permit to construct a new single family dwelling, at; 1) proposed construction at more than the code maximum height of 2 1/2 stories, 2) lot coverage more than the code permitted 20°fo, 3)less than the code required 100 foot setback from the top of bluff, located at: 5205 The Long Way (adj. to Long Island Sound) East Marion, NY. SCTM#1000-21-5-11 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 determination that the proposed action is INCONSISTENT with the below listed LWRP polices and therefore INCONSISTENT with the LWRP: The review addressed the less than the code required 100 foot setback from tfie toa of bluff. In 1975 a Covenant and Restriction (Liber 7969 oaae 274) was alaced on the lot which is included in the subdivision known as Pebble Beach Farms Clause 10 prohibits the construction of any Dart of a dwelling northerly of an approximate 100 foot bluff set back line The text of the clause is included below as figure 1. lo. An owner of a water front lot facing on the Ionq Island I Sound shall not construct any part of the dweiling northerly ' of the approximate 100 foot bluff get back line shown on the filed map. unless approved by the Town of Swxthold. ; Figure 1. A large portion of the proposed single family residence occurs in the setback area. In 2009 the Board of Trustees issued a Wetlands Permit for a single family residence that met the 100' setback condition The permit has since expired. It is recommended that the Board clarify the need to encroach into the setback. Policy 6. Protect and restore the quality and function of the Town of Southold ecosystem Policy 6.3 Protect and restore tidal and freshwater wetlands. E. Maintain buffers to ensure that adverse effects of adjacent or nearby development are avoided: 1. Maintain buffers to achieve a high filtration efficiency of surtace runoff. 2. Avoid permanent or unnecessary disturbance within buffer areas. 3. Maintain existing indigenous vegetation within buffer areas. In the same Wetlands Permit issued in 2009. the Board of Trustees required the establishment of a 50' wide non-disturbance buffer. The buffer was memorialized by the filing of a Declaration of Covenant Liber D00012603 Pape 669 by the land owner in 2009. It is recommended that a perpetual 50' non- disturbance buffer be shown on the survey. Further it is recommended that the Board relocate the proposed 8'x8' drv well landward outside of the non-disturbance buffer.. Please be advised that the Pebble Beach Farms Covenant and Restrictions• clause 2 prohibits the installation of modular buildings. Pursuant to Chapter 288, the Southold Town Zoning Board of Appeals shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Jennifer Andaloro, Assistant Town Attorney _ _ _ Office Location: ~~F SU(/Th, Mailing Address: h0~ ~~O Town Annex /First Floor, Capital One Bank ~ * 53095 Main Road 54375 Main Road (at Youngs Avenue) N ~ P.O. Box 1179 Southold, NY 11971 ~ • ~O Southold, NY ] 1971-0959 http: //southoldtown.noRhfork. net BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809 Fax (631) 765-9064 August 8, 2013 Mark Terry, Principal Planner LWRP Coordinator qUG - S 2013 Planning Board Office , - 4 ' Town of Southold t ~ Town Hall Annex - ~ .~~n~' Southold, NY 11971 Re: ZBA File Ref. No. #6680 FORDHAM HOUSE LLC./BOUBOULIS 1000-21-5-11 Dear Mark: We have received an application for a new single family dwelling, 3rd story, lot coverage and bluff setback. 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 ;Weisman - Chai on By: Encls. g~ L.~ f~ovb~l~s `may" 5 T! 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ND.03y ~ l r ~ 3 w N'~ 2 (Vy , C nn„ttTV np CI ICC FORM NO. 3 T~ ~ NOTICE OP DISAPPROVAL DATE: July 24, 2013 AMENDED: August 6, 2013 TO: Stacey Bishop (Bouboulis/Fordham House LLC) 150 Waterview Drive Southold, NY 11971 Please take notice that your application dated July 22, 2013 For permit to construct a new single family dwelling at Location of property 5205 The Long Way, East Marion, NY County Tax Map No. 1000 -Section 21 Block 5 Lot 11 Is returned herewith and disapproved on the following grounds: The proposed construction on this non-conforming 33 005 square foot lot in the R-40 District, is not permitted pursuant to Article IV, Section 280-18, which states: "No building or premises shall be used and no building or part thereof shall be erected or altered in the Low-Density R-40 District unless the same conforms to the requirements of the Bulk Schedule and of the Parking Schedule with the same force and effect as if such regulations were set forth herein full." Bulk schedule allows a maximum of 2 %z stories and a total lot coverage of 20%. Following the proposed construction, the dwelling will feature 3 stories and a total lot coverage of 22.4%. Furthermore the proposed construction is not permitted pursuant to Article XXII Section 280-116 which states; "All buildings located on lots adiacent to sounds and upon which there exists a bluff or bank landward of the shore or beach shall be set back not fewer than one hundred (1001 feet from the top of such bluff or bank." Following the proposed construction the dwelling will have a setback of 61 5 feet from the top of the bluff, at its closest point. This Notice ofDisaDaravai was amended on Aut'ust 6 1013 to address new information submitted by the surv o orized Signature CC: file, Z.B.A. Note to Applicant: Any change or deviation to the above referenced application may require additional review from the Southold Town Building Department. FORM NO. 3 NOTICE OF DISAPPROVAL ~ DATE: July 24, 2013 T0: Stacey Bishop (Bouboulis/Fordham House LLC) 150 Waterview Drive Southold, NY 11971 Please take notice that your application dated July 22, 2013 For permit to construct a new single family dwelline at Location ofproperty 5205 The Lone Way East Marion, NY County Tax Map No. 1000 -Section 21 Block 5 Lot 11 Is returned herewith and disapproved on the following grounds: The posed construction on this non-conforming 33,005 sq_uaze foot lot in the R-40 District, is not permitted~ursuant to Article IV, Section 280-18, which states; "No building or premises shall be used and no buildin or part thereof shall be erected or altered in the Low-Density R-40 District unless the same conforms to the requirements of the Bulk Schedule and of the Pazkine Schedule with the same force and effect as if such regulations were set forth herein full." Bulk schedule allows a maximum of 2 '/z stories and a total lot coverage of 20%. Following the proposed construction, the dwelling will feature 3 stories and a totai lot coverage of 21.8%. Furthermore, the proposed construction is not permitted pursuant to Article XXII Section 280-116 which states: "All buildings located on lots adjacent to sounds and upon which there exists a bluff or bank landward ofthe shore or beach shall be set back not fewer than one hundred (100) feet from the top of such bluff or bank." Following the proposed construction, the dwelling will have a setback of 64.5 feet from the top of the bluff at its osest ' t. uthorized e CC: file, Z.B.A. Note to Applicant: Any change or deviation to the above referenced application may require additional review from the Southold Town Building Department. Fee: S Filed By: Assignment No. APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS AREA VARLANCE HouseNo.~;_Street jrC La.it, Way Hamlet C-~A;~ /rlA2co,~.1 SC'TM 1000 Section o~ I Block~Lot(s) LL Lot Size . 7(o acu Zone I (WE) APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED ~'0?4 /,AOl3 BASED ON SURVEY/STTE PLAN DATED S~~r~i i 3 Applicant(s)/Otvner(s): ~oc.or-ho;K ifouSc~ GLC Mailing Address: a~0 GvK.r.,,~tvroa JC. (o,crciJw~eJt+ CT t7(oR~1 Telephone: c?U3' ~ 13-XD~ Faz: Email: NOTE: In addkion to the above please comphde below ff applipttoe ie dgned by appliaat'e attorney, agent, architect, boildar, eoatreet vendee, etc. and name of penoo who aaeet repreeenb: Name of Representative:_'TaciT3~ S t+a D for Owner ( )Other: Addreas:C=~n/a ~lT7SlKML7~.) S,;es r~-IC ISb tJci xv~~-~J fJ2 Sr'~.tri+o~b i19~1 Telephone:clOS-y3$a- Faa: `7loS-$y-to Email:vl-~ociL.la,~ctir~.i~-C.c.~ol•t.~~ Please rher! to rycc~/y wba you tonvpondaree to be matted to Jinni the above Hamer: AppiicanUOwner(s), Authorized Representative, ()Other Name/ Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN DATED aut.3 and DENIED AN APPLICATION DATED ~Z~aU, ~ _FOR: Building Permit ~T Certlficate of Occupancy PraCertificate of Occupancy Chaage of Uae ()Permit for As-Built Construction ()Other: Provision of tht Zoning Ordinance Appealed. (Indicate Ankle, Section, Sabsecdon of Zoning Ordinance by anmbers. Do not quote the code.) Article: iV -+(Xx-t:l Section: 980-+&' a-~Ro-ttG~ Subsection: Type of A peal. An ppeal is made for. (,~A Variance to the Zoning Code or Zoning Map. A Variance due to L?ck of acceea required by New York Town Law- Section 280-A. ( )Interpretation of the Town Code, Article Section ()Reversal or Ot r A prior appeal has, hss not been made at aav time with respect to this orooerty, UNDER Appeal No(s), Year(s). . (Pleare be sure ro rerearch b4fare cotnpleting this gwation or m11 ovr ~n for assistnnes) Name of Owner: ZBA FileR ~ REASONS FOR APPEAL (Please be spechc, additionat sheets may be used with preparer's signahve not~aetlJ: 1. An undesirable change will not be produced in the CHARACTER of the neighbor or a detriment to nearby properhea )f granted, because: .fL!/SJrcT P,~ypiIC71/ I S Locq ~ rb /.J r7N AxrJV of NflSr~_ /7olslrS~ S/TuA~cp o~ ntc cct~ D<-- Svc I~O.2lto~ eF ~ 2co.~. wrTl{ p,„r_y 3 NcMi S 7Ma1rpluir t~'ts~ !lt78ig NOrJ 6.uco A6cc'/''tu~rE,~ OuJ.vca9 /Sy TFrL l~cYji3cc-' /6gVCn flV.t.AAS hIU.M1-ltrzekJ;ur~(~ /aSSCX. ~ i~•tc--" Wcfi/ frNq 7}+c: L•S. S'a/,.IO 7a 77-~-lucr~"nt! ~Nt ,S'u/~ccT 92uv~r+.Tr /S 2r~,o~vc-cY ~tl?A2-. ~'(JI~l7Jn.Fl~La~, Tail /4KC` (~11'C!'L /~7C2Jiic`.G.L4.Uyyy Si )/cC`/-IRMC-.t /N 7'MC~A>~U9 2. The beneftt sought by the applicant CANNOT be achieved by smu method feasible for the applicant to pursue, other than an area variance, because: i rlt- Gcu~,t p,_,Q,J /ta;; AcR~,q.a~ ~.xzYy ,,ru.,uc~ ~ . /~S PcSS /;3LC' /N CEO[.. 'iU rT/ct e,q/:J7a!.•J ~}t~' ~.v ~621IZ.1 of TNT ~-c~~..~ F~n:~rVNO T#1~ iNC~D/ic.[..~A nlO'1,.~ S~/4.?C--. W~77i /fit-"Sac-cT~'771~~ /t771~ ~S.v c.cl?4, IT/S fb~-- CoS,i/c-n~ /-l.'!-~OC;)L;.t' I (/j .lT /S l~'i~C/+-10.vr ~ ~~s 6JN:Y4 /N -I?INT IT /cwi,NaS /i OF NIS NaM(CZArIO { /o,LC-xT C~,~ ~f- /3~so v/+s-may fMOat;vc-S7N~-viSUA~ ASia~=cTnch/F7lt~ /ua.tioF Tl~.• Na.tt~' A~aa sl~rc~ T>r /tcA2F,acFs• iHt. 4-r~JJNO tJi~.C A.GT qiI lN~nc~ (?`.i RJy OTNc-2 ~,'W H-i7r.(: 3. The amtnmt o re ' requesCed is not su ft /1-TGtiax ~ /f /N?eGV~:$ Or?~y ~}s~ cAiase-' u~ /Jr.;~,~.a~ 7"pp:>cxl,oHy o~ I'rrc Su/S~c..i Pz..:~vc.;y ,-l"}+c' ~i~c:~.~'Co~.~r~rn r°o ac rt ~'',~U~ Sib 6+~ Nan r'.~,~ i7c-.z.,~ ~t(SL/ .~6r) u/« /Sc-''(SU,3s;grilc~y~A¢or~= G,~AO~~ 4. Tha vari®ce will NOT have as adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: 27 LJ/c.C I..l Facer'/Mp/O%~%/~+~ ~aSTo~-,J Sf~c o< TNT P~,;,wrnr (S)7 4.Wy OF /7PPac~04NR--' Y4TA/NiIJC- :.JACC.t A,.lq ?~"i;c-r7al~}J. utYc2cN;7~ '(NAT SC~.nCN /S ,{Lq}-"-cT 7~ rx4Sro.J rD..l~ c'ni.azM VJlNC- rJuC--- rn 7tae /rv~cvFtrL t~Ytn/NAG c~rJ cvrcrJ cNt°~oYco /Sy i t+r= n.t=~roc?s~ c:u ~s~w~cno;> w/ti acaa Fig T r+,; l~wlorc4~ eG /x~v,~ ~v r •-`-~'J ~l' V.7 C.`Nt-3tC04tYJ~/ /;~L~IPK: jlil:" /ftra~Tl+lcat_Vr 4c'7'q~d~ '7'O ~'IQ/VL ~ / 5. Has the alleged difficulty been self creaud7 {k} Yes, or { } No Why: /Nvl.~~~"j Ctyali a...ic-"nJJ W Fay Jri:n,r?.w~t-r) <o i. "+71~ ~-cr u~vc.~-~ /L~-.;.~~9W J.gc.o~ j jla(1=~ WZK.~ /S~ !moo ;.fSUC S. NCcJ~~IC.Y ~ TNT Chi: hl/L~~r~t~+i/LSir~ ~ ~ 7l iJ' ~ ~t~DrK cd rift i7gc" J:vic~ J~ .3t<rco%.?c- /1rJ Da/.c,:2 /•kw/c-- ~ !1!J /~~ulc~ Are there any Covenants or Restrictions concerning this land? { } No { }Yes (please famish a copy) 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. l Signature o€~~tlicant or Authorized Agont (Agent must suhiait written Aulbor'vstion from Owner) swum m fetbte roe mis3~day ~ . af~_. ~ Notary Public COIUNiE D. BUNCH Notary Public, State of New York No. 0"s B1J613b~~5Ea Qualified in ruffolk County Commission =xelrss April t~, a_Dl)~ Kenuet/: Woychuk L. S P.O. Box 153 Aquebogue NY 11931 (631)298-1588/Fax 631-298-1588 August 1, 2013 R1 \ Town of Southold Zoning Board of Appeals Southold, New York 11971 SCTM No. 1000-21-5-11 The Long Way, East Marion LOT AREA UPLAND OF TOP OF BLUFF: 16,245 S.F. LOT AREA UPLAND OF COASTAL EROSION HAZARD LINE: 14,820 S.F. 14,820 S.F. X 20% = 2,964 S.F. PROPOSED DWELLING FOOTPRINT: 3,315 S.F. = 22.4% EASTERN REAR DECK SETBACK AS MEASURED TO CREST OF BLUFF = 61.5' K'~ TH 1ti.W0 ~I,S~2 APPLICANT'S PROJECT DESCRIPTION APPLICANT: C-: c-~r~ CQS~t~~.~ S~1cS i,Jc ~So.t~LOwDATE PREPARED: U/ 1. For Demolition of Esistiag Bnilding Areas Please describe areas being removed: d/~A II. New Construction Areas (New DweWng or New Additiona/Eztemiona): Dimensions of fast floor eKtsneiett: $a ~ x 4c.' Dimensions of new second floor: Sa',ct,l~ Dimensions of floor above second level: ~3 ~ x a3 s' oy! g~ j-~ a ~ n~ - a. ~ s C~ r ' /o Height (from finished ground to top of ridge): <3 5' Is basement or lowest floor area being constructed? If yes, please provide height (above ground) measured from natural existing grade to first floor: III. Proposed Construction Description (Alteration or Strvctaral Changes) (Attach extra sheet if necessary), Please describe building areas: Number of Floors end General Characteristics BEFORE Alterations: Number of Floors and Changes WITH Alterations: n? 5'~a~ Fka,,s~ a rnc.! IV. Calculations of building areas and lot rnverage (from surveyor): Existing square footage of buildings on your property: ~C~i Proposed increase of building coverage: Square footage of your lot: Percentage of coverage of your lot by building area: V.)P~arpoaeofNewConstruction: L~I,u~a nx~J s~,~~~ Fr~~.,r ~ ~w::~.~4. o~ 4-ram Sr LJ~1;J /J VI. Please describe the Iand contours (flat, slope heavily wooded, marsh area, etc.) on your Isnd and bow it relates to the di~icalty in meeting the code requirement (a): PW~~+~-y 1 S N~„~y ~~J~io ~ w rtt g dC oU-.~L2~a inn ~ I~u~ wn i 2c-c:4' ,nnlo L.ipvascn c. ~Lb:. T/3; O..~r nor ~'i~~~~ d„Jo A..J'D "N1a ..u a ^/6 _ .tea t1.a ~2F~ ?°Winc~,~ %71,a~ 1_loc !a/A~~,~ ~C~u » RKh L.g:.,w Rf q A ~.J !1v 7?.c>! wJt-Yr y{Titi 1~ki4naSt Please anbmit 8 sets of photos, labeled to show different angles of yard areas sdter staking corners for new constriction, and photos of building area to be altered with yard view, anoli QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION A. Is the subject premi listed on the real estate market for sale? _Yes ~No B. Are there any pro osals to change or alter land contours? No Yes please explain on attached sheet. C. 1 J Are them areas that contain sand or wetland grasses? /U ~ 2J Are those areas shown on the survey submitted with this application? 3.) Is the property bulk headed between the wetlands area and the upland building area? Af^~ 4 J If your property contains wetlands or pond areas, have you contacted the Office of the Town trustees for its determination of jurisdiction? ~ S Please confirm status of your inquiry or application with the Trustces: Ac,_~n~rirJV ZrSA ~~+r.nn iNaTtuJ and if issued, please attach copies of permit with conditions and approved survey. D. Is there a depression or sloping elevation near the area of proposed construction at or below five feet above mean sea Level? ~D E. Are there any patios, concrete barriers, bulkheads or fences that exist that are not shown on the survey that you are submitting? a1a 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? Jet ~ If yes, please submit a copy of your building permit and survey as approved by the Building Departrnent and please describe: G. 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. N~fF H. Do you or any co-owner atso own other land adjoining or close to this parcel? ~~D If yes, please label the proximity of your lands on your survey. I. Please list present use or operations conducted at this parcel ?/+u+,~"r~ Lo r' and the proposed use N~•J Si~C.~tc' Ln.u r~Y fp„q ~ . (ex: acisl'ng single family, Proposed: some with garage, pool or oNer) ~ (9~ t 3 Author[ ~'si re and D e f% I~ "QUESTIONAIRE FOR FILING WITH YOUR ZBA APPLICATION" SUBJECT PROPERTY: 5205 The Long Way, East Marion B. Are there any proposals to change or alter land contours: YES The survey for the Subject Property notes a shaded "pie shaped" area labeled as "azea maintained by others". This shaded area was inappropriately filled in with outside fill, seeded and maintained as a lawn by the adjacent property owner, creating an unnatural bluff that appeazs to have contributed to erosion issues on the Northern and Western side of this maintained area. Additionally, this same neighbor has at least one pipe draining run-off from his gutters (presumably) onto the Subject Property, which has caused erosion concerns as well. On the Western side of the Subject Property, the Pebble Farms Beach Homeowners Association has constructed a new retaining wall in response to damage from Superstonn Sandy. The Association intends to fill in this new retaining wall azea with appropriate vegetation to help stabilize the azea. Our intent with this proposed new construction is to slope the Eastern side of the property towazds the Western side in a manner more conducive to erosion control than exists now by following the natural slope as it exists on the Northern side of the property, utilizing appropriate retaining walls and vegetation as needed. Additionally, the adjacent property owner will need to remove his drain pipe(s) and install proper run-off containment in accordance with Town erosion codes. The Subject Property will also have appropriate run-off containment per Code. AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS ~J/!~ TOWN OF SOUTHOLD WHEN TO USE THIS FORM: This form must be completed by the applleant jor any specfol use perm/t, sftep/mr opprova/, use vaNance, area variance or subdivirion approval on property wdhbr an agricuftural ditbkt OF wilitln S00j~tofajann operation located br an agrleulmral dlstr/ci All applkaNons requbbrg an agrhstMrraf data stalentent rnust be referred to fhe Sayo'obt County Deparbnent of planning !n accordance with Section 139m and ?39n ojthe General Municipal Law. 1. Name ofAppGcant: S-xac~y iSiSNoV-rn„'~;,~,~ c~,J7-;w.c~d ~ Sucs i,~c.- 2. Address of Applicant: I wn~v,o ~ ,o~ J'o„.~v~~ 3. Name of Land Owner (if other dtan Applicant): _ra I~n,vl u.nt~- ~c_ s_ 4. Address of Land Owner: ~o Ca,_a~.,~;v,~ oz L1~-~.u~~.~ t 5. Description of Proposed ' Project: CiiN.Ynanct~a~:i aE a N~~ Si N:.I~ ,G~•~~~ /1~ti.i~- 6. Location of Property: (road amt Tax map number) i 20, 7"H~ Loti6 eta. ~ w S i ~A v . J 2l - S - l / 7. Is the parcel within 500 feet of a farm operation? { }Yes ~No 8. Is this parcel actively farmed? { }Yes No 9. Name and addresses of any owner(s) of land within the agricultural district containing active farm operations. SuffoIlt County Tex Lot numbers will be provided to you by the Zoning Board Staff, it is your responsibility to obtain the current names and mailing addresses from the Town Assessor's Office (765-1937) or from dte Real Property Tax Office located in Riverhead. ~ NAME and ADDRfiSS I. 2. 3. 4. 5. 6. (Please use the back of this page if there are additional property owners) _ f 3~l i 'Z~ ~ 3 Signature `App t Date i~ Note: 1. The local Bosrd will solicit comments from the owners of land identified above in order to consider the effect of the proposed action on their farm operation. Solicitations will be matk by supplying a copy of this s[atanen[. 2. Cotnmenis rettuned to the local Board will be taken mto considertion as pert as the overall review of this application. 3. Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above. The wet for mailing shell be paid by the Applicant at the time the application is submitted for review. anao Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART t - PROJECT ItIFOnMA710N o be M or i. APPUCANTfBPONSOR z PRQIECT NAME S-z~-~ ~slsHOp, r?.~~a c~~r~~1s,~stc.r (~owrw~ I-~wJ~~-~Lc 3. PR03ECT LOCATION: ~~UJ -T~F1t. Lt~l., lJraA, l-~S~ miar tu~.7 ~JrJ S' r'f'U~-1L PRECISE LOCATION (Street address snd rotl 6rlsnmctlane. prm'iraM . ek., a Pn~ meP) ~(=(5/SLL-r (Sly-aCN ~'Y~IILV~nS CVuLU(.Y'U ~YJ i ~ J ai~j ~T~-]l" LC~u LJft.~ r C.~S i lY1A JL.(t)A) C/O "~1C-'L U~V ~.IA~r 11s~}!-TO THE G21toNT O(-"TT\~ lei v+ A~4-TS, 10.JV ~.v~$'t7~#c G-rJ~ O~ ~i~_~ CR.iL- Q~ -SNL- 6. DACTgN iS: Espernisn Mad~oNaYeaBa~ 8. DESCRIBE PROJECT BRIEFLY: Ce~ra~a.~.aci1 JJ o G ~ ~Jci.S S I N c.cs; ~ti r a y r{~^-ram- AMOUNr of LAND AFFECTED: kAlay sues Usmaoely 3O saes e. vHLL PROPOSED acnaN cDMPLr wm+EXISTING zoNex3 oR oTNER EXISTING LAND tSE RESTRiCT10NS4 i34Yes ~ No MNO, dseaw laby 8. WiiAT lS PRESENT LAND tlSE IN VICHNiY OF PROJECi7 RasMsMW ~ kldmdrlal ~ CaminemW ~ Alpiailue ? Park/ForosUOpen Space ? Otlrer o~ct3YSLC:- ~c~viceaFicr<rnS iJ~v~z~ph.ro.rr - r'Lc=Srrxr.j"ftAL hlJ~.~3'uSi~ 10. DOES ACT10N tr1VOLVE A PERMIT APPROVAL. OR FtA1DtriG, NOW OR ULTMAATELY FROM ANY OTHER GOVERlMAENTAL AGENCY STATE OR LOCALyt Yes ~ Ns n Yes.1st aperlq(a) name aM pemYtlapprovak: 17. 6N Gl,~i.nnrT Sa..~Iacx~~-r'a.~N~u.rr~S ~c~znar~ /ti~~~tu,o (SLaIo Pcx_v..~r ~ 2(=zl~r~ 17, ~ ~ - N o~J~..L~-r6~ICala.J tc-rnx+_ 2n!a r`a°.o~~a~pL -w'o 11. DOES ANY ASPECT THE ACTION HA1IE A CURRENTLY VALID PERMR ORAPPROVALY Yes ~No RYee, Uat agawy(s) mms end perm: 1`~~ P[nJUr,~Co 12. AS A RESULT OF ACTION WILL EXISTING PERMR/APPROVAL REQIAItE MODIFICATION? ' Yas I CERTIFY THAT TFE INFORMATION PROV~EDABOVE IS TRUE TO THE BEST OF MY 1070YNJ3>GE ApptrmnVsporoername: 'i~iSN ~8~ Spnaaae: if is In the Coastal Area and you are a state apw~cy, complete the tal Assessment Form tN)~ore esd with thls a~s~sment 1 PART II - IMPACT ASSE38MENT o be Lead A A DOES ACTION _ CEED ANY TYPE I THRESFIOLD W 8 NYCRR, PART 817.44 M yes, coord'mete Me tevbw process ald uae Ble FULL EAF. Yes No B. WILL ACT10N RECEIVE COORDINATED REVIEW A8 PROVID®FOR UNLIS7FD ACTIONS IN a NYCRR, PART 817.8? H No, a negetlve daWratlon a superseded Dy amaler hvoNad apersy- ~Yes No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWMA3: (Meaers may bs herdhirn, N kaPok) Ct. EldNep i grralq, wleoe a a 4uealy or glrargay, moms Msak, aslgep ssale Patlem, none wash productlon a dlapoaai, pobreid for aroaion, drahrpe a lloororp prvbbrm? Explah blellY (10. C2. Aeatlsjdc, aariaWad, ardlseobplcY, hklorle, a dhsr nahrd a uibad rewurcas; a carvraaraY a rlelpllborlrood charadsR E~Ish briefly: C3. veadanoa a tauw, aen,,naflaan a warfare spades. aipriiBesd naetlw, a areaeened a amrgaee apedr7 Esplah Ixb1Y• YLU C4. A oamsr~ib/s adN6p Plans a goats as dlkWy adoplsd, a a Uwps h uea a hlrrRY d uw d Ma a aaer aeand rawness? ExplWr aleey. C8. GraNh, ellbsegrNd derabprnwa, or ralabd aCtlNtlr lady b ba hMroed by afs proposed sdbn4 E7~Idn brbfly: ?~-O C8. Lap bml, shat tNrrl, wmraaWe, ai ollrer e1leG6 ad Mleralled h C11.5? E~laln brMfly: C7. Otlbr hpatls (hdudbp darer h usa d eNla quarleq or IYDe d ~YYl Email brl~lr: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONe1FJVTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIROIeAENf AREA (CEA)? Yr ~No a Yr, axgain brMay: E. IS THERE, OR IS THERE LN01YT0 BE, CONTROVERSY RELATED TO P07ENTUIL ADVERSE ENfAL aAPACTS4 Yes ~No HYes, expldn brMily: PART III - DETERMINATION OF 8NEi~IGANCE (TO bs tanPleled by Apsrwy) INaTRUC710N8: FawdladvsrpelbetidsMNNdebove,ddsmVrlsydrdlrerRMSl~af~I.MIge,Mnporlantaualsrwieee~WoL Each etalct should be aseessad b connxtlon vA81 ib (a) ssahp p.s. uAwl or nlraq: (b) prabaDiflry a? ecaadrg; (c) auratlorr: (d) sravambflay: (e) psopraphiC seape; and (f) Ileprdhlde. H nsasawyr, add atladaranb or rafaancs suppoAkg matelwt. Elarae tlret al~lrmtlons confab eufadsMdsNibehowtlrtaarelsvantadvwaelnpaUShavebeenldsntllNdandadsquaMyaddmwd. HayJSSdonDolPaRllrrasdlednd yes. aledelulllblaaorl of tIQIlY1CarI0e mwtevaluaM ale poWrad blpaddalspropaedadlon onUls~ dlaregxk8a otBNr CEA CINdcBYsbmeayouhweidenMedanearnnlepoMAialylNasorslpdiratadseraeYnPadswhkhlMYaeaa.TlNnprowsdtlledlybria EAF arwsbr prapaa a PaaMire dwlardia4 Chsdl nit ban a you haw delNmYled, bred an ar idalmelbn and andyak above and any suppatlny doamNaaaar, tf fat Ba prapoeed actlon vn TrW[ h 8ily d edVer68 elflAf0lailerlMl hlDaEb AND provide. al eWdarlarb r rr000rary, the reasons auppoAbp aYs ddermhaeon ar ype G PART II -IMPACT ASSESSMENT The proposed construction of a Single family Home on the Subject Property located at 5202 The Long Way, East Marion, WILL NOT result in any significant adverse environmental impacts due to the following: 1. Subject Property exists in an already established community, Pebble Beach Farms, which contains single family homes similar to what is proposed on lots similaz in size and location as the Subject property. 2. To the best of my knowledge and belief there have been no endangered species of plant of animal identified or found on the Subject property or in any location within close proximity. 3. The Homeowners Association has an ongoing project to repair damage from Superstorm Sandy on the Western edge of the Subject Property, and there have been no negative effects environmental effects from work done in such close proximity. 4. The Subject Property will be surrounded by hay bales and silt fencing during construction, thereby mitigating any potential negative effects from run-off. Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shal l 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 Boazd of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# - ~ The Application has been submitted to (check appropriate response): ~~nn Town Board ~ Planning Dept. ~ Building Dept. ~ Board of Trustees ~ h'~ 1. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital 0 construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permi[, approval, license, certification: Nature and extent of action: Location of action: So205 ~ Lib spy ~=gS'~MA2~dn~ Site acreage: P `'](a ~c,~="--r - I'resertt land Use: ~/,ficA.•.; nT' Present caning classification: rI4 c, ~c~1.at~ 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name ofapplicant:~-n.T ;Sum - ~ . c=rJn ~.,~-i'~^. T,,.> f'r v u (b) Mailing address: cap c~?~c,.J ~ (c) Telephone number: Area Code ( ) (D 3i - qU~ f3 R Z ~ia K ~ ,r- 84 i a (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ? No ? Ifyes, which state or federal agency? DEVELOPED COAST POLICY Policy I. Foster a pattern of development in the Town of Southold that enhances community character, • preserves open space, makes efiicient use of infrastructure, makes benetScial use of s coastal location, and minimizes adverse effects of development. See LWRP Section III -Policies; Page 2 for evaluation criteria. Yes ? No ? (Not Applicable -please eaplain) E' rr~ L Sll ~ V ~ O.J A io ~2c-a 70 , -v,c u'7ai ,J = ~ uN ~ ~ f.~-yi_._ ~p,u~ f cN~c nc•-fir ? ,r~cL~ M'~zr- e ~(H'~4 - As ~r.S A P,ta'oc51,r.~,,w [.n,ort ;'7Jt cc- qF :-aie: ,f~'taaa~c n cu:JSiktct_71JrJ /S >0 '•.tiOliq"i ~c-.A c,Jn3_~..,~. Wi-~ati~ iJ c7..~,cn.- ~o ern:.,. Mcro, ~ w~wa~J N ~M :'N~' AH:" ~ i?ICrtw~6rt. /.T ,~.i 4..IL W, rH fu-' C me ~ 71.t' ~ ~~.,M?,v,M Attach additioml sheGS if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III -Policies Pages 3 through 6 for evaluation criteria ? Yes ? No ~ (Nof Applicable -please eaplain) P~UdLG_ ,~7~-'-) I~oL sJ'%, i ~Cte. /fir: N/ C7oti! lSu ~..a t RM1[A f u -?-o W ~L- IJAJI:~ M: ,MO,IC'T n,J "llil? SAnnc: i Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section ID -Policies Pages 6 through 7 for evaluation criteria Yes Q No Q (Not Applicable -please explain) Pta~.sn c:v.,r,, u,,,~ r tiL ,N;,..~ = ,¢r~s-air rte-rn„~ ~:=r-rw~m ,sy ra:ms~~,s n- ru~ra n. 13J aT rwcc r..wrc ~ [cn•r~`r.~co~re~nostamJ ~~c iz,,.~, QJU" c»~ acs c ~ r~Xt]SrJ..) nazt•~ c.tearan wxae..,arv.-rk~xey free.,rss .s`tw.5uwr ffr~TlJ Jr,F rAie GuT Foe nei'tr rc' aJo Nr.N m t..ri~ (~r!ln.wv t~Ka~ or ~ rnrsZrsa L~ o ~ s ~ , t>= c -ro Dtn ~ ti ta.~tc?~ r)J mac;- rNw,w,.dt C4' tJ1,an [~larc.u cr~.~-~" SC,US[~L~ Su AS ~ dam" a~uar7.~ c,;ao 1 w:czpel~ ~:S ita c~ i 6 ~ ~tiT 71 lX2XL ?L ~ AttachadditionelsheetsifnecassaryS~ Ac rwr ~e ecc;c,c vr~rs c~C ,.ytz,~ Gnr;,,,~ ~k;~~,ys;yt. ~ucr, a.u+ rv c.~> NQS~v vy'iA.X~~r ~ ~+"'t i:C_SPF1s 1~=+~ru-m -CUcNi tJiSNt".1 yAt~O 7v (ZuN~4~~J "N.9itr~1!_° lti PdSIr6C~; 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 -please explain) ~S pLs-VIOU}f` A.tcar'1~w<,r~ A~' c ~ ~i.~~ AS ~ riQ r` ~ r .v ~ 137n ~ r~g2ran..~S l~~/ ~NCrL:AUieJt. e.~%}r[: JU,~cr f1u`~wiTV AiJtT fc.rxJG ,nl a S'r6nr,/n~Pknd.J ~ tare: rit rl rc [,O:J,J A~?J ' ProiNr,r.st. ~rrparco cknr„+ D~aar c~,sL ~.enxru 7U cra,crc,i a?a~ h.t Lur1~ /,~...e.> c,;,urrx.ucrvf.~ t,,: ~ AfSrsn 6J .S'YJ!3r/~aWi~ 6¢,:a~r~ ~t.~r.x,~ S'~oreruz..ti~ AfFccre~utw-c-zr:-vnn~w cum fop ltv~/~-ra+a:J nnro _~INIJ F~J:-. LJACLCIGYKttnNL EMliCra, Fn2A^.n C6.N~~ B+r' /A: 14N6~,,• ~~?~LL1' l.~Li 11ti.10CL-~1CIAwrG~Y \S~2'dr/F?~Y~ C~a,,~s w.~ ~dtFUCm ,.vro t~c.f ue~c-s' /+fiwa~+arv VEG~nv,isJ K::'aiD~ n~ rsG,(,~ 7~ S?ror~n<~' 6~c:ltfn Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LW1tP Section III -Policies Pages 16 through 21 for evaluation criteria Yes ~ No ~ (Not Applicable -please explain) I~.Rcic_ r;~-r~ A.rac~~. r~ c.~:xcs tv ru-6~ usC-10, Attach additiotal sheets ifnecessary Policy 6. Protect and restore the quality and ttiunction 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 Q No © (Not Applicable -please explain) t ~rlt~c= Ax.~iMrs~. ~ c.i.s.;rx..~cca~aJ c,~ ivy Grikx) P,-f~~-^`^Y rJ s~~~ un~ AP,~ ~~,t„cy pFaRa_ tR_-/~aan ~r.r moo- rr W n ,~nN,ic„ r7c-uc~..;~r-rcrr'" ~~.r~ ~ c= ~~.J aF 'T7iFVr[_ ~r~ w/~ /yN C%uNARXsd Fi1L 'w'- at? A CN61.:.:' ~ I'~ fi::M ~ Q ~ PL[.~/ l; uJ`~N .P~ ~ CuWr T W7~[_ Gt`Ilti ~-tt~ ~POLJ04tA it' AID-14SURt't 7'0 ~.i2cr rllL-:P V.1l( ~/~ll E2z ~6~till- [~Nt~A, (~F 74i~GVT~ 41~~ ~~3c: c! L/ht.c/lf '7o c:,,rmJ {fir ,-CF /-esvnn~i c~ ArL~~,•,o~Air ?r~ srana+~i /<<~i.:a: crn~...r Ai N.~r~.+o ~~CrLf Cta.k..~..~v AND [y~t~SA(t,T i~l,~nk, tY~~tr1f .lam PQ li ~iJ'l[.uGai~4.7t f'ikJ1~W ~4Kal~ MN `baaaL 7a ~('h iL-' t 1LAIn1AL ~ AIYD ~pL -u7~.~ Cl- Nxw19d J F1A~-Art+7 C+2CAib7 NCIbN¢[1i Attach additional shcets if necessary Policy 7. ProteM and improve air quality in the Town of Southold. See LWRP Section III -Policies Pages 32 throngh 34 for evaluation criteria. See Section III -Policies Pages; 34 through 38 for evaluation criteria. Yes ~ No (Not Applicable -please eaplsin) l~M:ha~ nf~ 4iNT/i~'~ ~T7r`r Attach additonal sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III -Policies; Pages 34 through 38 for evaluation criteria. Yes ~ No ~ (Not Applicable -please ezplain) Act_ c.:.~s~ ma-zi...~ t~ ~ 6v c~w,.;:~ t~nic+. ~ G~.u~~r ANn P~AU.o fa a~.,-.~:.s~YO;z ~oc-7~c ~.i,L ~ ~2 ~Ltao!`ai_ of .Cm~ ~ ~1crs .]ai / L, L= l3cr P.w?~o~w t~iJ J-~ccn.~J T A/uA J'arL.Ce=rJrXrJ iS~ Nn~is~(~,~5 ANO 1>Gr Fraekr-.. 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 III -Policies; Pages 38 through 46 for evaluation criteria. n Ye9--~ No~ (Not Applicable -please explain) Piu1~2r' tJKL ,wr /A+PA CT SuLi Acct-71 Attach additional sheets if necessary WORKING COAST POLICIES Policy I0. 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) G~i/--L n,S" f~F}`xf Arx, W~ Y.i rrWW~4~R- UJ~~~ IW L3lJGKN(A 3Sf P~a-S c.-r~ fxarJ~~ 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 - please explain PtoJCC.i rliaµ ov h-u/~ -wrc.~ nafrnsons a~ ~n..w ` ~ro~.c¢a' Attach additional shcets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III -Policies; Pages 63 through 65 for evaluation criteria. 0 Yesj~? No ~NOt Applicable -please a%plain 1WL$ AaY- JT/Y~ L AN~/ AC-.f f J~ ~ i~G 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 P~ic~rm na.; ~ unc~~n.~_~ G>'~~ K~r c-~~w~ .rwti A,w N=~ .c.,-,,~-s - ~ra~ 3`d Floor vs. Attic: The Letter of Disapproval states the house will be 3 stories...instead of the allowable 2- 1/2 stories...because of the fixed stairs going to the attic from the second floor. A) The Client is seeking fixed stairs in lieu of the more typical pull down stairs: 1. First and foremost, as illustrated by the attached attic schematic, the attic only encompasses the center portion of the house...the rest of the roof system will be manufactured truss. With a roof pitch of 7/12, the collar ties will be situated at 6' 6"...below what NYS Building Code allows for habitable space. Additionally...the space is clearly mazked as "Storage"...which is the Client's intent. 2. this is cleazly a high end house, and pull down stairs would not befitting the chazacter of this type of construction 3. the fixed stairs aze hidden out of the way, whereas pulls down stairs are normally near the stairs for greater ease of access. The "Grand stair case" is a focal point of this floor plan, and will be made with imported stone, custom railings and trimmed with imported cherry...the client does not wish to walk upstairs and be confronted with pull down stairs in the hall. 4. With the open floor plan and balconies on the 2nd floor, pull down stairs would most likely be visible from the 1st floor, again affecting the character of this type of construction. B) Client is seeking approval for an attic balcony. Preface: Client is duplicating the FIRENZE plan as seen on www.donaazdner.com but with less square footage, no pool and no grand front entrance 1. The attached two rear elevation pictures (Marked "1" and " 2") are from the above website. Client wishes to duplicate the look of the rear elevation by adding a dormer and small balcony with the 2 Grand columns as shown. 2. note on picture "1"...the roof pitch is 5/12 and the balcony is taller than the Client intends to build. Client intends 7/12 pitched roof with a balcony roof to match... for an overall height of 33'. "1" is intended for to show overall look Client is attempting to achieve....Greek Mediterranean. 3. Floor Plan mazked " 3" is off the referenced website, and is intended to show how the 2 Grand Columns for the attic balcony line up on the reaz deck, which at only 12' deep at its greatest depth, is small by comparison, again lending to the fact this is intended for cosmetic purposes only, though it will also provide shade. Client's floor plans aze contained herein 4. Rear elevation drawing mazked "4" shows the reaz with the small balcony and without the Grand columns the Client wishes. In addition to losing afternoon shade (house faces the L.I Sound), the chazacter of the reaz elevation is compromised without those columns. 5. As established above in "A"...the attic is just that...a storage space with lowered ties. There will be no door to access the balcony from the attic, just windows as shown in "4". 1 vv Q , ti iY at . ' ~s? ~ S'JI,~- i Y • t ~ t ~ 1 ~ i ~P, ! "4' y + .R t,~~ .~'yy1 _ r "r ~ .iF ~ ~ t ~?tF ry,~. ~ l c ? L - ~ l s`~~C M, s fi . ~ 1 L ~ ik, ct y~r i,...x ^~y .ti . J g t_.~ ?Y 71 u t;sa 1 ~ ' 1.r 1- fr L~ ~ , ~r~~S,:+~d't. a. '7. J,~.t ~ .d.` r• 1 ~F ,i~a,'.go L,~.. ~ ~'rj¢,+ f ~3., t .4,~ i ~~$l a r! f .71.f. .ate f 1'L c y ""'?c"'C~: ,e.+ ra . ~K- I: r ~ >y1.. 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I . i ~ I ~ / \__a~_~I ~ \ % / \ j~ j~ \ - ~ ~ ~ i' ~ / \ \ ~ \ i ~ ~ .i" ~ ~ ~ i. i' ~ ~ r ~LO Clt_ I `A ~~?E~ auu o s zot3 30ARD OF APPEALS f ® r ® ® i ! , ..J ~ I I I I I I I I I I I I I I I I I I I I 11 1 1 11 I I I I I I I I 11 I I I I I I 11 I I I I 1 1 I I I I R-A-V1J}I y lyf~ 1 1 I I A1~}I y Ii I I IX 11 AtlXININI IIA/ 1 pXll IMAA I III~11 IIpI NIp NIIIAI 1 Ip IIMM pINl N1 IIIp 1 t 1 I 1 11111 INip A I t M 1 Ipll IIAININ IAIII IN IMAp NA AI AI IAIN i ANII INIp I pNll I~Iydyl yp ~Il py,AlyA A~II~I _I= =1_ I 1..600]J_YY~{IIl!!O] II II 1- I IAI11/1/1 I 111111,11 I 1111/1YA1 I1 I 11 11 11 _1 e e 8 8 II IIY1111 It/1/1X11 IIIIIAIMI II II II II II 11 II B 8 ® II 11 II jj jj II II II I 1 I 1 I I I I I I 1 I I 1 1 I I I I I ~ ~ -~-1 I L1~7 8DE HP/ATIDN 11 II pII H1 `-~1 ,IIIIIY II( 1 1/1111111 I 111111YY1 1 II II II ® 8 B B II 111111111 IYIgI1gG1 111111Y 11 11 Ir _ _ 11 11 11 II II (1 ii ii h_.,________~_~______ 1 FKOFR BOE 9.EIA710N -_.I_- _ ~ ..n.aa .e. _ . . e " W6. 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R ~'1 p~pc~, f7:~.`, ~P~ 9+ ~,'~"Fr3i t ~"4 . wp H , ` a7~, . i. S _ - .1 r~j s~ P ..r't'b~`'. •'+~k~' ,s~~ ~ :'I ~•p'~'~'`~r~jY'~33~'~.s.:"T St ~.4) .hY~ 1 J ,'•.1 {~t ~ I J~"4+F:a JJ bra,,. ~ g ~s.-t~ ae ..v. r°~~ J`.1 9i' ~ T ~r 4 ,f- Y ~ - ~ ~ u~_ ~ at e' Jj, ~ Nor' rtt ~ 8~` b . r ' ~t *s a ~ r^~ ~ qt See ~ "w ~ II"" . f , ~~~j :~~l(Y ~>:43 ~ ; 11`~i ~Y ~ I/A!~ yYY PLS' 'yi~l 4 ~`3Mr S~A e.4{ .,1~- .u i~.• ~y4. 'i(fi k. i4: a.i '^Qv `Ak7• ~ y t•'_ s . ~..;t le +e~t r ~ ~bY~ ~ '~f ~ ~ ~ ?`yFyaiT ' ,y a .i'~,v~ ~ x ;?ice r rri~i` 4 ~ M ~ I a III 'F~ F~ .1 h - y% L ~ h r- y ~ ,y c 4 ~ ~ ~ ~ ,e ' ,r~ ~ ~;k ~ Lek ' ~ ~ ',-4 ~~Y '6"EY• 3 Xy~1 fart ~ 1?~ ~^Y. ~ ~ ~ h ~ ~ ~M' ~b)?1` a,, ~ rt ~ ti ~ ~ ~ ~ ' t ~ w• , x h~ + a ~ "`tiS~ ' s~F P x' z~. K ~y 1 "VECr iy ~ ' Y k1, ,~yi ~ 4'A' ~ v'~~ ~ s~ ' n' ~ ~ sat a.f y„ s , v'~' ~ ,t ',a 1 e.i r r ~t ~ t~ ,r ~ ~ v- , ;A~~ ~ i to ~ ~,~~~Faf' s E i Its ,c ~ ,L. 't 15. .'g f t 1 i eu~~'d. ~ ~`y~.. .J+: fi ~ittl:' a . 4 f# ~'lv ~Y ~ F ~ 'aPp' c~.ikt+'~* s~ -:r'~ e . ZI ~Y ` _s`7'C ~T + ~ t r~ M1.~ ~ :b r :~"`y x;.° 6.~ a% ~ ~ ~ . rl ~ Mp s t ak ~ `~ri ¢}ice %s .-s ~ 1 ~J"` r ~ 'K % a 's' ;f ~~j.. ~ fYr 14 a~=`E. ~ ~ ~~jG~" ~.p~T{, Y;1 ~A zv ~ 'yv!c-y~ .Y yS r y~ i 4 .;F i } - 'ti4e~ ~ APPLiCANT/OWNER TRANSACTIONAL DISCLOSURE FORM The Tow+t otSoaWoM's Cods of Ethic prohibit coaDicb of fatereat an the part of town ofRaers sad amployep. Tke parpoK aftip/tID77n IgtD.prevWa iakrmation which can Bert the town otpossibie eonnlet of interestaad allow It to takt wkatever selip.trtteeewary toavoid snare. ]'rE,x1~#_~!tAsAi~ s~"~"~ut.iS . ~n)~S u,~ ~ I~,c xACF' 1~Or..© raaM NaSr- GG.t=, tusl nm0. same, tddle initYl, uolesf you are applyhtg in the name otsomtoae ebt Or odor eaaty, net q a . e~an.trao, mdleate the oMer person's or compaay4 mma) ~1!'tiGATION: (CYECk all that apPiY) 71a#'~ SaiWing Permit Trustee Perm@ ~C Coastal Eroaton Mooring Planning w a h yens company, spouse, sibling, parent, or chlhl) 6nve a rolatioaship trith any oflleer a 'i~ivn aJBonihold4 "Rd:tioaship" includes by blood, marriage, or busioep lnteraL "Bwbleu ~ ' ~t ~ a partnership, in which the town oDicer or empbyee has even a parfbi ' " ` ~ ~ ~ t a ration is which own ofRcer or cm to ee owns more than 5'/a of tfie ,"'x *'s~~ eorptr ~ P Y yy r A~15 4~ ~ r~ ~ ~~6 UL r ~ t.. IFS ~ NO ~ r ~r,~r , z the balance of tbis form and date snd sign where indicated. 1 q= {~v 1 i~leTerrp olSeathoid fi ll I III I 44 ~teradt'(the applieanUagenUrepresentative)snd the tows officer or employee. 1~ !L ' a~;t~oagp D) and/or describe in the space provided. ~i ~i~, r apRa.e, sibling, parnt, or child is (check all that apply) 3.~,,. ,~~e aharamf the corporate rtock of the applicant (when the appliant t a I~ ~ ~~dl+~,~~ ~'tutY4aprest in anon-corporate entity (when tde applicant is not a corporation) adtkaapplicaat or e x , r. s"~, ~a r~ ~ ~ ; 7 { yti.; ~;r; ~ V~t'~ul..1S,_~ r~Fy t „ !RZZATI4N t"4?9~s the A~plic~ta not the Ovntet) (1'nat#a~oPeatY owner's nears) th'8~) (r/, . r ~sQ~ r E R C - i~''"§1`U 1"5~ f }t t ~ e ~~d G~ #Wr VRB~~ F T k ! • M t .x x ~ u t x ~ ~ u ~ xr.M' ~~h ` ,ir a ' Jy; q i ~ 6"~r~•,'F A~` ~ a ~ m "~3 s jF a n a ~ .-S .,r x*4 Y v4 v x w = ' *Y"ytt r~~G+~~ t~~d ~ f7i ~i, ~ a ~ as TA rk"rk v'~x fur. ~~'y~` £.rN 5+^ h}~ ~rr^' g~ ~~9 ~+ie yy 1 - Ya x 5+3 k~r~ lac ~ vx~' ~M~, { Ad~y~~s~ < X p £an A,~F Y'~-fir a `tiw# ~t+y ~4+~i ~Y ~ ~ F~+K ~ "pry ~ }F < f rt l 5 r 7 3~ i~ ly ~ f ~ v~K ~ t ~ xkl t a .hy~ a t~~ o v gy~ac if ,~fia t e r t, t if k4 `s~'x~ ~ ."~"~_'~r~$w°w" xx~ a X ~ ~ ~ ty}tte t ~ ~S'°1 ~ ~a, ,p~ ~$4r ~r ~atq~~~x~ty"n ~r. .a ~is1 i h~' ~ `{t F k"ro k3 Fl i7~h \ ~y ~i°~yi"L+ a4_ M v`' f ' f z,~+ x, rr.. r i ~ i L~ _ 'F o- e w v~ $ r F 3 w Ili ¢l 1 °4 ! t~ '4Ut _ p R `s ~ E ' ~ I I 1~~ p~,, ~ ,yre ~'d~ ~?t- $X~ ~ f c >~Y a T ~ 4 p ~ gg~~ . , y~ 'iL~ f ati u ~ ~ y 12 % i ii~" !F~ 3 '6 F ~x. 'V r. 4 h '£"F' 4 '1... , ~ I ~ I~ ~ .~y 0.0. I d u ~r~ ~ Y~'4~1~ 4 i A4S ib~)~ t h~'i,~ s fie' 4 it 4~i ~ ~ i~ A qg ~ ~ M i h t N` `q ? ~ ,.K... AGENT/REPRESENTATI V E TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Eth:rs °rah:hits conflicts at intereat oo the Dart ottowo otticera and emolovees The ouroose of this form is to orovide information which can alert the town of oosai6le coo0icta of interest and allow tt to take whatever action is nceessarv to avoid soma YOUR NAME : ~~S1~P S1JCi;~4 (r •Leyr~ G~-J.ir ~a'`- i ~'v iNL T?it 7 (Loa[ acme, first ame, middle inifri, nolrta you are appiyfag io Me Dame of someone else or other a fity, saeh a a company, If so, iodiuh the other peraoe'a or Company's mma) TYPE OF APPLICATION: (Check ali that apply) Taz grievance Building Permtt Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other (activity) planning Do you personally (or through your rnmpany, spouse, sibling, parent, or child) have a relationship with any officer or empkryee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including s partnership, in which the town officer or employce 6sa even s partial ownership of (or employment by) a corporation in which the towa officer or employee owns more than 5°/a of the shares. YES NO It you answered "YES^, complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant/sgent/representativt:) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided: The town officer or employee or his or her sponse, sibling, parent, or child is (check all that apply) _ A) the owner of greater fhat 5•h of the aharea otthe rnrponte stock of the sppliant (whey the applicant b a corporation) _ B) the legal or beneficial owner of any iotereat io a eoncorporate entity (when the applicant is not a corporation) C) an otlieer, director, partner, or employce of the applicant; or D) the actaal appliuat DESCRD'TION OF RELATIONSHIP Submitted this dad ot~, 20 I' ~ Signature ~ ~ / Print Name ~ ~`(J~~ `~19Nck~ ~-3i 1Q S,._~ TOWN OF SOUTHOLD PROPERTY RECORD CARD E STREE/T ~DS,,/ VILLAGE A, DIST ////SUB. LOT -7Y~ Q h T'Fd ~e41.~ ~l `tie ~0•~ ~a ash`/~1a1-/dIy ~ 2A6~@ ~eaC~ / d.Y.r++ J fi F RMER OWNERS-~ R~~"~D +f u)f N E A ay ~ - i V /ya .r S yy TYPE OF BUILDING ~e~~~e ~Ba~~t ea/J~.~iic 2ES. SEAS. VL. ;1.~3 I FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 'y 4OD P- 9J Q 8 t I-• a . / a 2 ~l L- i o0 2 3 a d 2 3 Q a s' 11 0 ~c)L. ~ ~ ~ ro I'78~. SaAw7wt~ goo,' I Imo ~z~ I~ zo l ~DO <; D ,X' ~ o "-L. ~5i1' 5FS1-Ri ~ ~ G z-L ~ Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowksnd DEPTH House Plot BULKHEAb Totol