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Home My WebLink About1000-21.-5-11To OFFICE LOCA11ON: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 , tf OtCOUN%*t� MAIUNG ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM Leslie Weisman, Chair Members of the Zoning Board of Appeals From: Mark Terry, Principal Planner LWRP Coordinator Date: February 28, 2014 Re: Coastal Consistency Review for ZBA File Ref FORDHAM HOUSE, LLC #6680 SCTM#1 000-1000-21-5-11 FORDHAM HOUSE, LLC #6680 - Request for Variance from Article IV Code Section 280-18 based on an application for building permit and the Building Inspector's January 9, 2014, amended January 16, 2014 Notice of Disapproval concerning a permit to construct a new single family dwelling, at; 1) lot coverage more than the code permitted 20%, located at: 5205 The Long Way (adj. to Long Island Sound) East Marion, NY. SCTM#1 000-21-5-11 The 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 proposed action is CONSISTENT with the policy standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Southold Town Zoning Board of Appeals shall consider this recommendation in preparing its written determination regarding the consistency of the proposed a ction. Cc: Jennifer Andaloro, Assistant Town Attorney Terry, Mark From: Terry, Mark Sent: Friday, February 28, 2014 3:38 PM To: Toth, Vicki Subject: FW: FORDHAM HOUSE, LLC #6725 Attachments: 6680 Inconsistent.doc The past application was numbered 6680, the new application is 6725. It is the same SCTM#. From: Terry, Mark # Sent: Friday, February 28, 2014 3:09 PM To: Weisman, Leslie; Toth, Vicki Subject: FORDHAM HOUSE, LLC #6725 This action was reviewed in August, 2013 and recommended as Inconsistent. Although the applicant has furthered LWRP policies, I have one remaining concern: 1. The type of buffer is undefined on the site plan, last revised 12/28/13. It is recommended that the Board require that the buffer be labelled as an non -disturbance buffer. Mark Terry Principal Planner LWRP Coordinator Town of Southold 54375 State Route 25 P.O. Box 1179 Southold, New York, 11971 (631) 765-1938 1 Office Location: Town Annex /First Floor, Capital One Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 http://southoldtown.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809 Fax (631) Mark Terry, Principal Planner LWRP Coordinator Planning Board Office Town of Southold Town Hall Annex Southold, NY 11971 January 15, 2014 Re: ZBA File Ref. No. #6725 — Fordham Hese LLC Dear Mr. Terry: Mailing Address: 53095 Main Road P.O. Box 1179 Southold, N 1971-0959 We have received an application for deck addition in East Marion. A copy of the Building Insctor's Notice of Disa roval under Chapter 280 (Zoning Code), and survey map, proje description form, Are attached for your reference. Your written evaluatidij with recoqdmendations for this proposal, as required under the Code procedures of L Sectio 268-5D is requested within 30 days of receipt of this letter. Thank you. X,�� - c' Encls. Very truly yours, Leslie K. Weisman Chairperson By: FORM NO.3 NOTICE OF DISAPPROVAL 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 deck addition 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: DATE: January 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 lot coverage of 20%. Following the proposed construction, total lot coverage 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: $ Filed By: Assignment No. APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS AREA VARIANCE House No. 6:;Vb.5/ Streeter 2 SCTM 1000 Section _Block S�Lot(s) Lot Size 3 00 Zone I (WE) APPEAL THE WRITTEN DETERMINATION OF THE BUILDING giSPFCTOR DATED ),p� , 20 S% BASED ON SURVEY/SITE PLAN DATED Applicant Owner Mailing Address: n 3 Telephone: Fax: i&,r 8yio Email: C�, 1swdU ►- AoI Citi, TT v NOTE: In addition to the above, please complete below if application is signed by applicant's attorney, agent, architect, builder, contract vendee, etc. and name of person who agent represents: Name of Representative: �� 71 cel sfor (Owner ()Other: Address: /5D Telephone: Fax: Email: ,016 C-0/`;. Please check to specify who you wish correspondence to be malted to, from the above names: ( ) Applicant/Owner(s), V Authorized Representative, () Other Name/ Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN FOR: DATED and DENIED AN APPLICATION DATED -r Building Permit () Certificate of Occupancy () Pre -Certificate of Occupancy ( ) Change of Use ( ) Permit for As -Built Construction (Other: A"ra 6zV-0C tGc- Provision of the Zoning Ordinance Appealed. (Indicate Article, Section, Subsection of Zoning Ordinance by number . Do not quote the code.) Type ofA peal. An Appeal is made for: A Variance to the Zoning Code or Zoning Map. A Variance due to lack of access required by New York Town Law- Section 280-A. () Interpretation of the Town Code, Article Section ( ) Reversal or Other A prior appeal 04 -has, () has not been made at any time with respect to this se be s re t UNDER Appeal No(s). Year(s). / 3 (Please be sure to research before completing this question or call our officefor assistance) ZBA File# Name of Owner: REASONS FOR APPEAL (Please be specific, additional sheets may be used with preparer's signature notarized): 1. An undesirable change will not be produced in the CHARACTER of the neighbor or a detriment to nearby properties if granted, because:/'z? O" - J F YIGJvJ SursSZzc''i7 torrLc� f:cf J.Ni4%ZW 70 .Gz(-' c�ao/2,►P pt) 6URvjec/ �urG, lrG ✓.4444nlul G/Ln/0ZVI �tx?A,n1J A� /Q ��ACcnli 1iL*11 7y , AVSD t�iw �wS �N(sCrATlfl f !r^?,�N��fhs'�lG�4KS0C s 11AA11r 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: P � /S S L�Gr o,7N r4 I-- /JaiJ.LA(, �}Pro�2aPI,'y \ !s¢svc' �xv.? /Zr6Ni TU GNI Hpa�Jr4/G RT lJ, c r cL- .i0Nt4s qF TNC/ FoJ„�rhona,J csc� ars= GtisiOG'I ��Gc:,$S,T)9ri,•J6 r-74&- 3. - C&-3. The amount of relief requested is not substantial because: J'tTiSAae- 46(,rG�Scr`,�c-''Qu,,Grr.�Ljr1i 5 d� tsl/lu.J coss,rrw�a,✓� i�(� -7-07X4- C? 61- 6.1' 77&- DoT riGGI�'^•7 1Xtir aLt�'!'a fiL1A%71�'J / .C'd 14- 6ti.A JTb;0/% S T RS- IMtOOS'" As �T AtAY !`tlr(y AGAI,rSrT 4. The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: cd #G c- <3Lr tlgo✓cf (v2,IWGr-rlgdxG'r"o . �onlna�✓acG� iNc.- /rwpo.r� AC cPOiA6-r* / �"C?tgR/Jf GISAtOG/AJr LJITid /QCL U��dCsTs SG' i/jAClGJ AS acne_ AS Ti♦IG� b0� �JoJ r�tSTu,L/jlq�scG 5. Has the alleged difficulty been self created? { } Yes, or {)J -No Why: W lost roc.rn-,C. -rWL' -7vPA/-RPtr Y OF "T}ic sc1� �tiaP z�1 / f' WAY �`' Ac Garr rbcs PticPudc-,� hfvr�c� r.� ✓/R i,c�-(G I.J /Ewan- .F (%arc•cdt ,N ijc6� � { � lease famish a copy) � I %''�^S � cSluzrsA•�c� Are there any Covenants or Restrictions concerning this land. } No Yes (p ��,�✓ ,sS 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. Sworn to before me thi -2� da of MO V%.Ar�t 20 . Notary Public Signature of p cant Authorized Agent (Agent must t writte uthorization from Owner) CONNIE D. BUNCH Notary Public, State of New York No. 01BU61WW Choolled in Suffolk Gotmty s CommieEVIM APre APPLICANT'S PROJECT DESCRIPTION APPLICANT: Co. l�j1S& ' , CA)b Lb tiu SVcJ 1nk�DATE PREPARED: ► t t 1. For Demolition of Existing Building Areas Please describe areas being removed: U. New Construction Areas (New Dwelling or New Additions/Extensions): Dimensions of first floor e*te lien: ? NOW-' -12L s4 ,fir Dimensions of new second floor: Dimensions of floor above second level: Height (from finished ground to top of ridge): 'I ` li'I Is basement or lowest floor area being constructed? If yes, please provide height (above ground) measured from natural existing grade to first floor: �ls !7 III. Proposed Construction Description (Alterations or Structural Changes) (Attach extra sheet if necessary). Please describe building areas: Number of Floors and General Characteristics BEFORE Alterations: Number of Floors and Changes WITH Alterations: IV. Calculations of building areas and lot coverage (from surveyor): Existing square footage of buildings on your property: Proposed increase of building coverage: V5-- 7 alb �%b�+t: /SAS V orj /y, Square footage of your lot: 3 CW 7=66 ayi f4AAM0 70 7bor �� T �� Percentage of coverage of your of by building area: YSd/v l01'�catic-r� "�u�� " `='j'°�t°'`3 44.k�r- V. Purpose of New Construction: S/n.>, A m I c.c/ 1�W4 u r.J� vr,J ✓� ca�t7' �7-- VI. Please describe the land contours (flat, slope %, heavily wooded, marsh area, etc.) on your land and how it relates to the difficulty in meeting the code requirement (s): Vbv iin1G"i/L')Ll /-, a-jL .Al"J W /77-i G:-L&VAi78.J 61 le .AQ fgeS L49 7U A �tS AS' A ILG:SU t , C.-' %Ar/dyAZh�j .TILL /SGT G-7ClifOC✓l /) px4nS AoQ frcd b XC&,1144CA Zt- ��rLc=S1 Please submit 8 sets of photos, labeled to show different angles of yard areas after staking corners for new construction, and photos of building area to be altered with yard view. 4/2012 A. I' C. Go.r'rw cx'ti �ti� QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION Is the subject premises listed on the real estate market for sale? Yes — No Are there any proposals to change or alter land contours? _,Y --No Yes please explain on attached sheet. 1.) Are there areas that contain sand or wetland grasses? Xh 2.) Are those areas shown on the survey submitted with this application? No 3.) Is the property bulk headed between the wetlands area and the upland building area? ,(%O 4.) If your propertyCcontains wetlands or pond areas4have you contacted the Office of the Town trustees for its determination of jurisdiction? JurS Please confirm status of your inquiry or application with the Trustees AL,4% -n;j& LOA iVA 7&—J 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? ,t E. Are there any patios, concrete barriers, bulkheads or fences that exist that are not shown on the survey that you are submitting? Vo 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? _If yes, please submit a copy of your building permit and survey as approved by the Building Department 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. 11)/ 1 1) j >- H. Do you or any co-owner also own other land adjoining or close to this parcel?�_ If yes, please label the proximity of your lands on your survey. I. Please list present use or operations conducted at this parcel I)Ac" 7' and the proposed use SiA)&L4r lfa—i,�z (ex: existing single family, proposed: same with garage, pool or other) AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS TOWN OF SOUTHOLD WHEN TO USE THIS FORM: This form must be completed by the applicant for any special use permit, site plan approval, use variance, area variance or subdivision approval on property within an agricultural district OR within 500 feet of a farm operation located in an agricultural district All applications requiring an agricultural data statement must be referred to the Suffolk County Department of Planning in accordance with Section 239m and 239n of the General Municipal Law. 1. Name of Applicant: 9J -,4C -e 8 —L • (---AIO C4Sar(-A44r''�^) 4VCJ 2. Address of Applicant: )gb DA-- S u r'HOL�J 3. Name of Land Owner (if other than Applicant): r -o" Amvt tdnudxr 4.A -c- 4. Address of Land Owner: % Ct4xiL irJ&7v/,) az. 5. Description of Proposed^ Project: SJrJgLe 16µicV orJ 6. Location of Property: (road and Tax map _ nnmhPrl `.5.,% i T/fir L1Sw1C� 7. Is the parcel within 500 feet of a farm operation? { } Yes {j'-io 8. Is this parcel actively farmed? { } Yes DNo 9. Name and addresses of any owner(s) of land within the agricultural district containing active farm operations. Suffolk County Tax Lot numbers will be provided to you by the Zoning Board Staff, it is your responsibility to obtain the current names and mailing addresses from the Town Assessor's Office (765-1937) or from the Real Property Tax Office located in Riverhead. NAME and ADDRESS R 4. 5. 6, (Please use the back of this page if there are additional property owners) Signature Date Note: " 1. The local Board will solicit comments from the owners of land identified above in order to consider the effect of the proposed action on their farm operation. Solicitations will be made by supplying a copy of this statement. 2. Comments returned to the local Board will be taken into consideration as part as the overall review of this application. 3. Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above. The cost for mailing shall be paid by the Applicant at the time the application is submitted for review. 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part i - Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding, are subject to public review, and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item, please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency; attach additional pages as necessary to supplement any item. Part 1 - Project and Sponsor Information Name of Action or Project: f � FtAriL G l► -L �- Project Location (describe, and attach a location map): 6-.20S- LD J6 0,q 45M i MA1UJ J Brief Description of Proposed Action: drS VACA,Ji LAr Name of Applicant or Sponsor: Telephone: E -Mail: ry�o du-!� �.! � � �+al G3Nr �i &-rMS C:AC_1 U 0 Cd�JOC7 a 6,) VC. [ i J Address: /S -b 4JR eiu/as.l pc_ City/PO: State: Zip Code: �bc.l"7--A bd-/) /-1-k /I of -T 1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, NO YES administrative rule, or regulation? If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no, continue to question 2. 2. Does the proposed action require a permit, approval or funding from any other governmental Agency? NO YES If Yes, list agency(s) name and permit or approval: "DO 44- / Taw a 7 a-. c . TO�J,J ac -O (. J(`/ G L - No�J rL� i a� vcr 3.a. Total acreage of the site of the proposed action? -7& b. Total acreage to be physically disturbed? • tZ acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? • -I C., acres 4. Check all land uses that occur on, adjoining and near the proposed action. ❑ Urban ❑ Rural (non -agriculture) ❑ Industrial ❑ Commercial XResidential (suburban) ❑ Forest o Agriculture ❑ Aquatic ❑ Other (specify): ❑ Parkland Pagel of 4 5. Is the proposed action, a. A permitted use under the zoning regulations? b. Consistent with the adopted comprehensive plan? NO YES N/A K XC 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? NO YES Y\ 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? 1f Yes, identify: NO YES X 8. a. Will the proposed action result in a substantial increase in traffic above present levels? b. Are public transportation service(s) available at or near the site of the proposed action? ASSQc.,A-noJ "21L -,4T -DC WAy" Tb 1&iVArr*_AcN o,0 AO jA&CrAJ7_4j -T - C. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? NO YES 9. Does the proposed action meet or exceed the state energy code requirements? If the proposed action will exceed requirements, describe design features and technologies: ff�RS �!-LIJ�iGsf d'74� G6htP�'��'- (.l�pusi � NO YES 10. Will the proposed action connect to an existin pu li rivate water supply? S:C If No, describe method for providing potable water: NO YES 11. Will the proposed action connect to existing wastewater utilities? If No, describe method for providing wastewater treatment: -/.771G LS-I M NO YES 12. a. Does the site contain a structure that is listed on either the State or National Register of Historic Places? b. Is the proposed action located in an archeological sensitive area? NO YES 13. a. Does any portion of the site of the proposed action, or lands adjoining the proposed action, contain wetlands or other waterbodies regulated by a federal, state or local agency?/ -r- S O UW O b. Would the proposed action physically alter, or encroach into, any existing wetland or waterbody? If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: NO YES o�= x 14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply: &.Shoreline ❑ Forest ❑ Agricultural/grasslands ❑ Early mid -successional ❑ Wetland ❑ Urban ❑ Suburban 15. Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or Federal government as threatened or endangered? NO YES 16. Is the project site located in the 100 year flood plain? NO YES 17. Will the proposed action create storm water discharge, either from point or non -point sources? If Yes, a. Will storm water discharges flow to adjacent properties? VNO ❑ YES b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe: ❑ NO MYES /y 411%V44+ G&'_ 4)/7OC Z L=ttoSYaJ Cc�DGs' NO YES ! yL Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of water or other liquids (e.g. retention pond, waste lagoon, dam)? If Yes, explain purpose and size: NO YES \/ small to large impact impact may 19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste management facility? If Yes, describe: NO YES occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? y 2. Will the proposed action result in a change in the use or intensity of use of land? X 3. Will the proposed action impair the character or quality of the existing community? 20. Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or completed) for hazardous waste? If Yes, describe: NO YES establishment of a Critical Environmental Area (CEA)? I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor n": t3 e S>l-too Date: 6, ! Signature: T Y Part 2 - Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept "Have my responses been reasonable considering the scale and context of the proposed action?" Page 3 of 4 No, or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? y 2. Will the proposed action result in a change in the use or intensity of use of land? X 3. Will the proposed action impair the character or quality of the existing community? x 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area (CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit, biking or walkway? x 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate X reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a. public / private water supplies? / b. public / private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic, archaeological, j architectural or aesthetic resources? X 9. Will the proposed action result in an adverse change to natural resources (e.g., wetlands, waterbodies, groundwater, air quality, flora and fauna)? Page 3 of 4 Part 3 - Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered "moderate to large impact may occur", or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact, please complete Part 3. Part 3 should, in sufficient detail, identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant. Each potential impact should be assessed considering its setting, probability of occurring, duration, irreversibility, geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. Cu4)eI4-- A,cVut-'1y If A tbl.-."SI&VA-7NO &:le-PIJ` L-07— Calm(..)&&;, a-rrNer.) R �pLA�Jr►v�0 A ,9pp2ovr� .rvr3at✓il�artJ int c-xrarr,.scsr :zvvoJ S�0 yrzr /t(Y,/�k1cs1D C.�t+1 �/uit ci7 0� Cc�n1 �j RM d !� � S 37a iS4J/i�"� ScT/SAGr'.�` AnJo a i�i��'c-T�' AS Ua'c-c- AS' Ar,) cz8 i N�sc.vFtcyo SD � /SuFi�i�c 2<)&,V CAJ •PNa-VJ IriObr61�,JA J r �20��dc:� GJr3si a-<-'r-iw� c�tcL G�woj ,J ;-o �t_c_ Tari,J SdViJ Q j 7Ktoc__ f.0 OW L/r Q O 4/&-zcJ) f-kgtr QAc.cjJ A, )a sl Crn76 -r" P e-wc.-j r I&J l - c) t `L Do.4,) 7W(,, /-%D l i f'fl1 �CriGtr< o Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. 6 Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. C •tfy-o JZJC,S INC- rb/�/ Name of Lead Agency Efate _ �IiQGLz! l3iJ'Nc�O Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signatur R , ible Officer in Lead Agency Signature of Preparer (if different from Responsible Officer) Page 4 of 4 No, or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion, flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3 - Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered "moderate to large impact may occur", or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact, please complete Part 3. Part 3 should, in sufficient detail, identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant. Each potential impact should be assessed considering its setting, probability of occurring, duration, irreversibility, geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. Cu4)eI4-- A,cVut-'1y If A tbl.-."SI&VA-7NO &:le-PIJ` L-07— Calm(..)&&;, a-rrNer.) R �pLA�Jr►v�0 A ,9pp2ovr� .rvr3at✓il�artJ int c-xrarr,.scsr :zvvoJ S�0 yrzr /t(Y,/�k1cs1D C.�t+1 �/uit ci7 0� Cc�n1 �j RM d !� � S 37a iS4J/i�"� ScT/SAGr'.�` AnJo a i�i��'c-T�' AS Ua'c-c- AS' Ar,) cz8 i N�sc.vFtcyo SD � /SuFi�i�c 2<)&,V CAJ •PNa-VJ IriObr61�,JA J r �20��dc:� GJr3si a-<-'r-iw� c�tcL G�woj ,J ;-o �t_c_ Tari,J SdViJ Q j 7Ktoc__ f.0 OW L/r Q O 4/&-zcJ) f-kgtr QAc.cjJ A, )a sl Crn76 -r" P e-wc.-j r I&J l - c) t `L Do.4,) 7W(,, /-%D l i f'fl1 �CriGtr< o Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. 6 Check this box if you have determined, based on the information and analysis above, and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. C •tfy-o JZJC,S INC- rb/�/ Name of Lead Agency Efate _ �IiQGLz! l3iJ'Nc�O Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signatur R , ible Officer in Lead Agency Signature of Preparer (if different from Responsible Officer) Page 4 of 4 APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM 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: i'� t.-tL. l� `_� 1 j, Et- i�.iat / ' Vi c i� �•IFd, ;; l �t is c. (Last name, first name, Ffiiddle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance ` Trustee Permit V Change of Zone �— Coastal Erosion Approval of Plat Mooring Other (activity) Planning Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. `Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which t own officer or employee owns more than 5% of the shares. YES NO If'yoa answered "YES", complete the balance of this form and date anti sign where indicated. ?4*perm employed by the Town of Southold S>D #ttatioilsbV between yourself (the applieanUagent/representative) and the town officer or employee. ,Stapftroprlate line A) through D) and/or describe in the space provided. "Omplaym or his or her spouse, sibling, parent, or child is (check all that apply) "ineraatgrttter that $*/a of the shares of the corporate stock of the applicant (when the applicant is a ration) 001 trr betst+eficial owner of any interest in a non -corporate entity (when the applicant is not a corporation) ,:director, partner, or employee of the applicant; or appEiestttt — _ 1t 3 VVI AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees. Thepurpose 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 : Last name, firs name, middl initial, unless you are applying in the name of someone eise or Diner company. If so, indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Building Permit Tax grievance —� Trustee Permit Variance Change of Zone Coastal Erosion Approval of Plat Mooring Other (activity) Planning , such as a Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply) : A) the owner of greater that 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation) B) the legal or beneficial owner of any interest in a non -corporate entity (when the applicant is not a corporation) C) an officer, director, partner, or employee of the applicant; or D) the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this / / ', 1r 20 /(,/ Signature Print Name 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). 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#_ The Application has been submitted to (check appropriate response): Town Board M Planning Dept. 0 Building Dept. 0 Board of Trustees 0 2 . A _s 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) Permit, approval, license, certification: - Nature and extent of action: 1, u fat_ �Ckk/uyAf�- � L S ' �. 9 Ya N ayc` Location of action: , Ti p t,J�y ��s>'��•��J Site acreage: .7h /&94`s_ Present land use: Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: S— 73isu (b) Mailing address: /SbwA c,u/�c�J Ox-- (c) Telephone number: Area Code ( ) (oil - 90,s -- 413 S oz - (d) Application number, if any: -2 AA 1OA6,,�a -i i, t,J Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ❑ No CK If yes, which state or federal agency? DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. .Yes ❑ No ❑ (Not Applicable - please explain) .S'k 41c;u'' &,L Iat,Lj�g Ag& ua&-O / t -y 4 I,r- J /J,Oo c6"t.-rte 4f46/yleld.j Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LV -/RP Section III - Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No (Not Applicable - please explain) L)6t j' Av1--tJA%c1-Av4 K Aga J A4 ts'7W4c- on, A C� ua c- 6"4 ;.�4 6- "OVA4 2- 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 0 No 0 (Not Applicable — please explain) /.S� �.+� y �Tz A --IA Stg- Ax4d- Thy5�XctA4QGtW A fhi s i �i (Sc.o6 R44Jcz/'—A-JV .:� ✓tsc*c-T^ 714PJ (48%rn rlV+�i►Nccr Sc caJt� 0*7VOw- OC rNts cap A�Jo Pio i�,cr- ficJ.K ►�vc7ltc- (�i 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 ��(Not Applicable — please explain) ak �,�,',t,�n_�` ..,,.Da�-'.t_ i�[.�rdc�..r R-�.J'a �o qtr �,�r;�ecc.crJ Pc�—TIxd,J �7ccuio,.�Wi:xs • rco�a!'cro SiMucallrtt Ct)AjLzytil sGs aAgr- s t A N,, b",.JaGa- Qfcr Q 1sc,& r ,rr46 ooTb 4a,;- AUm nJ6-76&Sba - 1S T -b AJ 1e.--awj14)0 rsy jJL- a ,o, -b S'ouT 4 A-V 4t 'Mt"i Attach additional sheets if necessary is A2 -SQ S'/nJA`b%V 14116A ,naa✓cam &JA7-&t-7>aClc.ci J�Z „a n�t=swAntks C�Zo r,✓ot✓ra7vLlN�oorar Policy S. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III — Policies Pages 16 through 21 for evaluation criteria NZ Yes 0 No E (Not Applicable — please explain) #OuGC4r- cianot.,- AVAI4AllrGLf` �t��ia,cy,3 /uo" ACL 6&-"-Fnc.am- L5 SQ i! J�tu/dc'Zc.S %t>r� A°V�Jd� C-un�'70t,J�ytL�. 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 Ld No [K (Not Applicable — please explain) ,w7 n�o�c-r c� -rwtr AAS iTW f AJ L/J7bQ 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. See Section III — Policies Pages; 34 through 38 for evaluation criteria. Yes ❑ No (Not Applicable — please explain) _ E�1J KMtlni� /IIIL Ga1nTY9J�1tN/�N� 1 c,,rc.rCV uJ'c:0 tau �1AAc3 �G�1PaSc.ro r IJUMV 4 AMM WIGC �cr QL:ZIGF�J� lY✓ 70 Tu( -- 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 III — Policies; Pages 34 through 38 for evaluation criteria. KYesF]No ❑ (Not Applicable — please explain) t,O »LUA) AiAL-AA,0QAj 12L-rkJLJ SOCto aAJi1w'MA WL46.5-� M ?Jtopor� c.J�rT7�u�� WiLcL_d,, c,),t',>arn�c✓� tJ�rx►J t�o��oa�aa. �Vd)?yrtYc,C cJNicFt Wtcc_ /Q�r C' /Jr?cr►� llS iuw�sc-rot Atj , 7A cW_ t10A St7Zr vJc.C_ 4W—CX4AAkyX2 oQ "(d L7ta$�.t DALl-f4 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. ❑ YeLl No (Not Applicable —please explain) co ,JJ i a.c, c�t�a�� l7uLJ #.+Q i Aa ni ' WLw_, M,4 tS tAALc.-rio-r-- .GC`cr% R-iu eu4"e- AUC�_f Al (7(SSGA�/dc� !d �3A6/L r 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 III — Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ NoR (Not Applicable — please explain) atgaco c bt3j—, C4u>j -L-bc,.r AA-T i,rJt(our` 64y OX at, OBD tot r�vtc�'3 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 of Applicable — please explain 'WP �'✓J C64jzf -t n 1Jotf.f tWr iN✓Ot_✓c: /W/L. trJencr— htrtnti �nA�i.ttlt�- �2c:.fOJa.sirrr ,fig ASC`�cs t c,c rac r.� Abbe -- 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 R -Not Applicable — please explain A6fA uryGcSr,ls;yc v sJ 1�r 6W ^A) /W6(_t/t! A"3y 6 16rc4C /LNwAL_ 1_ao4w.j 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 .LclUca� GJn! J;,Gtcc i'k1J L✓1 t_c_ ac,- C'Wt.vuLr �'i ura lt�Gli "n1 iJ�1J'uc/� i1oY.J TNA; L�cce..o,l lS"6<..aw(. ��c.:J �Y.I� c�i�-t Ai..fo �Scf ff�%LS /�""2-tom AJO t-✓L�tGt1L �A?L'1p S (.i-(2 Jci �; �I h-�o c.�rc i1� ��-1— cC dr 'c3— TDPo6(ua(Jltic,ct_ lsSucsS ALv,�co �� L�Sizrc-n> clyz)e'b —T--kLp tipiu- S/V,Q�c►O '0 --)CO3J A(r o C✓ cn -l--6)0 7N) T14c �ts1�)Cc= �OyL �t�,tx A'S A Noxa S Ha) s IAOL,� cJ a 3 i mala,..) ( t Y'-' APP (Lc) vcec::) As APP<«O � w,e-e- lrlq<< is or- -iv- Nc-:-�4,49,b S 14 0u S C -r � -TU iA S ZC;az vi ej L -,--t 4 7 ,ti- %/ i "J S 7o 7'kc: c -x; s7 -- U n) 0/3 S i 4-4A C,—IL--O. • i, 1 v _ - { Y • yp RFS _ ',.`". �.64.Ap �p as .k•. , -` �` <, � I — _ E _ , +�� "' � �� -: r Q "'x~ � • moi'" i �� as �'S •. � ..t ��.'`..�. �}�; �', .'�cY'. "��' -.- .r .. ., 17,7; �. r e Ay v ape , ,,k.f i• :L`"'1 _' I ililt, w RIM Max .. ..- 'o". �; ��+,� t .e`f `fid'• � s t fid""`` =1►� i IJ(/jj• � I • •,C • + /meq=#fit �1T•� r � ,�r ��P�� • \, J„ ;,>k, ,'i WE -- Igo ...._ w 111 1 III'::1 11111 111 111 111 1111 111 111 111 1111 111 111 1111 111 111 1111 111 ..0 �I l �; ,—•,— ,••, �i'� aril one iii �1!I;l ,I111� � ►,..Lloo t III�II. I�11 m MN ■■n Omni k TOWN OF SOUTHOLD PROPERTY RECORD CARD _ EL STREET a0 j VILLAGE _DIST SUB. LOT -;a/y0 'Gme..n. �yyc Qea(�d O,;f.p IMP. TOTAL DATE ,Ueac� dry► �%i �. F RMER OV1/NERL' R��6) 6 e U0 �.1 1 1 i ter..- �t N E A .,,. � y �% {/' a 'M t /lc.�-�ic S W TYPE OF BUILDING SES. SEAS. VL.�tI W FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 2 3 G tit g JO l 6 �U l , l� ,3S� �,w+�l-� s cx�o,' t - ►70 �izZc� l�^- za I SOD �0 �` /� ? ►� o '- L �5� 5�1-Kti o � v �. I � �: L5 06 Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total 7 INFORMATION IN REGARD TO APPROVED SUBDIVISION Name of subdivision e e� SCTM# 10007 Subdivision approved by Planning Board on Subdivision filed in Suffolk County Clerk's Office Zone at time of approval 410 Current zone`' Date zone verified Clustered subdivision: Yes= No Covenants and Restrictions filed for subdivision: Yes No_ (see below/attached for details) Building envelopes shown for individual lots: Yes Nom_ If No, set -backs for all lots within subdivision: Front ,� Side yard__7, 5 25 Rear /7.5 � IOt� u{�CIZ S�awr Comments: 6/3.197 il�iiuc s*h4w-c nvr,11iw�ed Lv ('cr„ �1s1, aM .iN.�;i�o,_ %q'3i4 plan MQ c-- Low.Mc a -i Vy0,jr: 16+ (aynk wit, -ry4- a�Ooy� _M" I6N1 A soeLe,ch, FvkbO fi } -900SE ol-k � � / �� Page 1 of 1 co C2 ! ' �� (143) o 23 —� — 7 j 5.5A (142) l �t� GG .4A (141) wvs, (2) ry 130 (140) 1 a '14 `� .a 13 1 2A 12 � PEN SPA "Ell 40 A.9A 5;, 15 48 ' X43 �a 94 / M 15 LO 17 a� (72) 0% ,, (73) 9 1.3A � � (74) � r8a (1 7) $ �� ,�p0"5 .. ca http://gis.co. suffolk. ny.us/rpsIESRI.ArcGIS.ADF.Web.MimeImage. ashx?ImgID=4107ab7... 1/14/2014 FORM NO. 3 NOTICE OF DISAPPROVAL DATE: January 9, 2014 AMENDED: January 16, 2014 TO: Stacey Bishop (Bouboulis/Fordham House LLC) 150 Waterview Drive Southold, NY 11971 Please take notice that your application dated January 7, 2014 For permit to construct a new 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-conformine 33.005 square 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 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 lot coverage of 20%. Following the proposed construction, total lot coverage will be 25.9%. This Notice of Disapproval was amended on January 16, 2014 to correct errors. - Z) ;2-,% Authorized 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. S.C.T.M. NO. DISTRICT: 1000 SECTION: 21 BLOCK: 5 LOT(S):11 CREST OF BLUFF AS DELINEATED I BY EN—CONSULTANTS INC. /' I DEC. 2 2008 ti (AS SHOWN ON PREVIOUS SURVEY) / \ 1 34,\ IX / OPEN SPACE "E" Q / /, AS SHOWN ON FILED MAP . Tw 'p TOP SOIL 0.3' CLAY SANDY LOAM 15' SAND & GRAVEL TEST HOLE #7 AS SHOWN ON FILED MAP AVERAGE LINE OF BLUFF AS SHOWN ON FIILED MAP 100' SETBACK SETBACK UNE AS SHOWN ON FIILED MAP yAREA MAINTAINED BY OTHERS, LOT 141 STAKES do FLAGGING SET SEPT. 30, 2013 O;. �i / 1 N 0.4 TO SHOW APPROXIMATE LOCATIONS �� / i OF PROPOSED STRUCTURES I / 0 AND BOUNDARIES. A i , i� 1„ I I. r 0 X10. 4 56'' � I I I N PROPOSED TIMBER WALLS r (5 0) w BW(4$,0) o O` I pRo�°r>G o I II ! I TW(4 ,o) m 1 � I ��"l �t oGARAGg 11 11 i BWC44.0) uNOE 5 TW(44,0) GARAGE {O.F.(�0.0) 1 BW(40.0) 1 z 7.6' UNDER i 37.0' _ 52 -00 \� Z 80RY\-�\ S.7 � \ , ----` 50 2 RAIN FALL EVENT DRAINAGE CALCULATIONS: 48 vg CACA\\ ��,,� �\ �_ �Q'�\� - - 46 A)DWELLING FOOTPRINT W/COVERED PORCHES=3,845 SQ.FT. PROPOSED 5 BEDROOM mbo \\ \ o 1 3,845 x 0.166=653.65 < 654cf REQUIRED SANITARY SYSTEM \ \ c S6705Q 4 (2) 8'DIA x 8 DEEP DRYWELL=706cf PROVIDED 1,500 GAL. SEPTIC TANK �" B'DIA x 16' DEEP LEACHING POOL \ \ �O 0' FJ�� 9 1 CL 41.0 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 2,960 S.F W/FRONT & REAR DECKS: 3,845 S.F. THE STRAND AREA:33,005.98 SQ.FT. or 0.76 ACRES REVISED FOOTPRINT & LOCATION 12-28-13 REVISED TO 40' SETBACK 10-09-13 REVISED 10-02-13 REVISED 09-03-13 REVISED HOUSE/LOCATION 05-25-13 REVISE SURVEY 05-14-13 THE WATER SUPPLY, WELLS AND CESSPOOL LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS. ELEVATION DATUM. U.S.C_G_-+�__Y_