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HomeMy WebLinkAbout1000-118.-6-1.1OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 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: March 25, 2015 Re: Coastal Consistency Review for ZBA File Ref F1 MOSS, LLC #6846 SCTM#1000-118-6-1.1 Request for Variances from Article III Section 280-15 and Article IV Section 280-18 and the Building Inspector's December 22, 2014 Notice of Disapproval based on an application for building permit for construction of an accessory garage and a deck addition to an existing single family dwelling, at; 1) accessory garage proposed at more than the code required maximum size of 750 square feet, 2) deck addition at less than the code required minimum front yard setback of 50 feet, located at: 805 Aborn Road (adj. to a pond) Cutchogue, NY. SCTM#1000-118-6-1.1 . The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed actions are CONSISTENT with the LWRP policies and therefore 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 action. Cc: Stephen Kiely, Assistant Town Attorney Office Location: Town Annex /First Floor, Capital One Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 February 4, 2015 http://southoldtown.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809 Fax (631) 765-9064 Mark Terry, Principal Planner LWRP Coordinator Planning Board Office Town of Southold Town Hall Annex Southold, NY 11971 Re: ZBA File Ref. No. #6846 F1 Moss, LLC / O'Leary, Dennis Dear Mark: Mailing Address: 53095 Main Road P.O. Box 1179 Southold, NY 11971-0959 FEB 0 4 2015 We have received an application to construct an accessory garage and a deck addition to an existing single family dwelling. 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 268-51) is requested within 30 days of receipt of this letter. Thank you. Very truly yours, Board FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE: December 22, 2014 TO: William Kelly (O'Leary). PO Box 1680 Southold, NY 11952 Please take notice that your application dated December 12, 2014 For permit to construct an accessory garage and a deck addition to an existing single family dwelling at Location of property 805 Aborn Road, Cutcho u County Tax Map No. 1000 — Section 118 Block 6 Lot 1_1 Is returned herewith and disapproved on the following grounds: The proposed accessory building, on this conforming parcel in the R-40 District, is not permitted pursuant to Article IV, 280-15 C., which states that "Such buildings... shall not exceed 750 square feet on lots 20,000 to 60,000 square feet..." Following the proposed construction, the accessory garage will measure 2016 square feet in total size. Also, the proposed accessory building is not permitted pursuant to Article III Section 280-15 of the Agricultural Conservation District," which states; "In the Agricultural -Conservation District and Low -Density Residential R-80, R-120 R-200 and R-400 Districts, accessory buildings and structures or other accessory uses shall be located in the required rear aY rd." Furthermore, the proposed deck addition 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 Residential 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 in full." Note to Applicant: Any change or deviation to the above referenced application may require further review by the Southold Town Building Department. Cc: File, ZBA Fee: S Filed By: Assignment No. APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS AREA VARIANCE House No.Street Aj-:7 ; L _AA'' Hamlet CuTcA t )L SCTM 1000 Section 1 jS Block 4. ,- Lot(s) i . 1 Lot Size j, Zgj1'5Zone F—' I (WE) APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED BASED ON SURVEY/SITE PLAN DATED Applicants)/Owner(s): pe", 6' Mailing Address:_ _ j `� t 1!e>PAL_ F Telephone: C? i 7_0ZK:_fZE&ax: Email: NOTE: In addition to the above, please complete below if application is signed by applicant's attorney, agent, architect, builder, contract vendee, etc. and name of person who agent represents: Name of Representative: 11�U4_CA" *A for( ) Owner Other: kid,`r Address:. Telephoner ' ?ax: 6�j(- %1 •164- 1 Email: I11CYr1 6» Ark i nc f t3 x°1'1 Please check to specify who you wish correspondence to be mailed to, from fire above nalnes. ( ) Applicant/Owner(s), ("Authorized Representative, ( ) Other Name/ Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN DATED ' , C& "'Z O)i` and DENIED AN APPLICATION DATED,_K ZZ � 4FOR: Building Permit () Certificate of Occupancy () Pre -Certificate of Occupancy O Change of Use Permit for As -Built Construction () Other: Provision of the Zoning Ordinance Appealed. (Indicate Article, Section, Subsection of Zoning Ordinance by.numbers. Do not quote tine code.) Article: t Section: Zebe _ Subsection: iS-G l Type of Appeal. 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 ( ) has, V has not been made at any time with respect to this property, UNDER Appeal No(s)'. Year(s). research before completing this question or call our office for assistance) Name of Owner: ZBA File# (Please be sure to APPLICANT'S PROJECT DESCRIPTION APPLICANT: DATE PREPARED: L z 1. For Demolition of Existing Building Areas Please describe areas being removed:—A'k- II. New Construction Areas (New Dwelling or New Additions/Extensions): gAte-ACk- Dimensions of first floor extension: °Y4- X 6' 47p) i(4> go=ug - { Z' Dimensions of new second floor: Ka -9- Dimensions of floor above second level: �Qqi'L Height (from finished ground to top of ridge): ' �.' C'� 1 I• tvJ`�n� Is basement or lowest floor area being constructed? If yes, please provide height (above ground) measured from natural existing grade to first floor: &"i R- 111. 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 propety: � (.® Z �-- i-7 C, i . j' r - zszj::� . Proposed increase of building coverage: ZC D if; --5q, + ?JL4 mAce-- -4- Square footage of your lot: `j�(, tz .��.Qa �c¢, Percentage of coverage of your lot by building area: V._Purpose of New Construction: Vii'..,- AT I�>�Z-s? 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): COU -50Lfl'ld Edo &C ?✓ IAO - R� 1 "EO --7-> L-LTT-L- Ca to &w-LD.4 k- P3eAiZ 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 REASONS FOR APPEAL (Please be specific, additional sheets nray be used with preparers 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: � = V. -NL 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: 71 1 Irtfv u 1 b�f,. J i'�-,I�� wt 2 f'�1�d �► a iA4j --TO b PL4Z44Gj `-rP V4 - P �%Uz (-Z'Tl1-1aE j A -TL) '-E Gar 'T{4�AZ04 3. The amount n/of'relief requested is not substantial because: zo 4. The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: 5. Has the alleged difficulty been self created? Yes, or { } No Why: LAOS, (b Are there any Covenants or Restrictions concerning this land? •4 No { } Yes (please furnish 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. S to before me this da of 0. Notry P he BONNIE J. DOROSKI Pdotanr Puhlic, State Of New York (!o. 01D06095328, Suffolk>unty Term Expires July 7, 20 1�__... QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION A. Is the subject premi es listed on the real estate market for sale? Yes No B. e there any proposals to change or alter land contours? No Yes please explain on attached sheet. C. 1.) Are there areas that contain sand or wetland grasses? 2.) Are those areas shown on the survey submitted with this application? iq o 3.) Is the property bulk headed between the wetlands area and the upland building area? 0 4.) If your property contains wetlands or pond areas, have you contacted the Office of the Town trustees for its determination of jurisdiction? t -(t Please confirm status of your inquiry or application with the Trustees: jam, 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? W) E. Are there any patios, concrete barriers, bulkheads or fences that exist that are not shown on the survey that you are submitting?Please show area of the structures on a diagram if any exist or state none on the above line. F. Do you have any construction taking place at this time concerning your premises? 140 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. H. Do you or any co-owner also own other land adjoining or close to this parcel? _E'� If yes, please label the proximity of your lands on your survey. I. Please list present use or operations conducted at this p,reel �' E and the proposed use (ex: existing single family, proposed: same with garage, pool or other) t orL ed,A dhat'rj and Pate { AGE\ T/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The'fown of SoutholtPs Code of Ethics prohibits conflicts of interest on the P u t of town ofiicet•s and etimi •ces 'file mu -nose of this form is to provide information which caul aleft the town of Possible conflicts of interest •uid allow it to take whatever action is necessary to avoid sante. YOUR NA\•IE : (Last name, first name, middle initial, unless you arc app h:ng, in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's n:uue.) TYPE OF APPLICATION: (CIieck all that apply) Tax grievance _ Building Permit Variance_ Trustee Permit _ ) Change of Gone 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 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 pe son employed by the Town of Southold Title or position of'tll' t person �' Describe the relatiottslup bettv\n yourself (the applicant/agent/representative) and t��wn officer or employee. Either check the appropriate line A -)'through D) and/or describe in the space, rovided. The town officer or employee or itis or her sl'oll ibliog, parent, or cllilc!js eliecic all that apply A) the owner of greater that 5% of the shares corporation) B) the legal or beneficial owner of am, interest C) an officer, director, imi-wer, or eniployeewi D) the actual applicant z DESCRIPTION OF RELA corporatp,stock of the applicant (when the applicant is a u-coi'oorate entity (when the applicant is not a corporation) the applicant; o Submitted this clay or, 20 b / / Signattuel"f�C X-, Al Pt•int Name _ 011'a --MM K-�� L,,� ,I-' APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORNI The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and entnlovees. The nurnose action is necessary to avoid sane. YOUR NAME: I , . 1- ,. / 0— t A I r. . --r— _ Last name, first name, middle initial, unless you are pplying in the name of saneone cisc or other entity, such as a company. If so, indicate the other person's or company's name.) TYPE Or APPLICATION: (Check all that apply) Tax grievance Variance Change of Zone ' Approval of Plat Other (activity) Building Permit Trustee Permit dl Coastal Erosion Mooring 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 the town officer or employee owns more than S% 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 posifibilof that person Describe the relationslj�p 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. 'fie town officer or employee or his oto er spouse, sibling, parent, or child is (check all tthaatap y) : A) the owner of greater that 51/o of the shares of the corporate stock t the ap` piicant (when the applicant is a corporation) B) the legal or beneficial owner of any interest in �a,n6n-`cor orate entity (when the applicant is not a corporation) C) an officer, director, partner, or emp1ot%c of tits applicant; or D) the actual applicant DESCRIPTION Or RELATIONSHIP Subinitted this 2 �— day - f �!^e , 204 Signature printNarnCIV�ilge 'ta y r,`. 1�.. Board of Zoning Appeals Application AUTHORIZATION (where the Applicant is not the Owner) residing at MbF-4--i5 }&-rk- (Print property owner's name) (Mailing Address) do hereby authorize j ..L�, T ' (Agent) to apply for variance(s) on my behalf from the Southold Zoning Board of Appeals. (Owner's Sig l� (Print Owner's Name) 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 usepermit, site plan approval, rise 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 239nn and 239n of the General Municipal Law. 1. Name of Applicant: 2. Address of Applicant: 3. Nar of Land Owner (if other than Applicant): 4. Addre s of Land Owner: 5. Descrip 'on of Proposed Project: 6. Location of P?Verty: (road and Tax map 7. Is the parcel within5 0 feet of a farm operation? { } Yes 8. Is this parcel actively ed. { }Yes { } No 9. Name and addresses of an wner(s) of land within the a, operations. Suffolk County Lot numbers will be your responsibility to obtain the rrent names anKocated lii (765-1937) or from the Real Prope Tax Offic NAME and ADDRESS 1. 2. 3. 4. {}N pKeultural district containing active farm vided to you by the Zoning Board Staff, it is ig addresses from the Town Assessor's Office in Riverhead. 5. 6. (Please use a back of this page if there are additional property owners) Signature of Applicant 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. S undW- o OWNER Ji rl� STREET Vi LEAGE* - DISTRICT SUB. LOT 74' > Y. !:,',-X,i`-.EFO --v;', WN ER Olt/N E ACREAGE n SW TYPE OF BUILDING RES._; SEAS. s. VL. I FARMOMM. C. IND. CB. I misc. LAN D I "'A P. TOTAL DATE REMARKS V—XP-1-2 A -d X,1-7�-) C, Ir -f r, 5g�, J<n Hf)l A -14-o i NILL- 77 c fugiy ,L - ho— L I Z , -7� Y� e' z 4�� EW- BELOW ABOVE ABOVE Farm Acre Value Per Acre Value Tillable I Tillable 2 -f-illoble, 3 Wcodland swampland ----------- Brushland House Plot I col 72 1— ■■■■■■■■■■■■■■■■■■■■ MIMMEMMEMMEMMOMMM `''`� �d MIN Foundation /E'%E', Bath ■■■■■■■O®®■M■ ®MIMMMMMMM-Moffiffiffiffiffi91INN �U ■■■■■MMI■■■E■■■ ■ :nsion 1 ■■■■■MI '�fic'�!i■NMMNIIFM�I �`a j,�_ Basement n . f ��. Floors ■■■■■MIS ■■N■�PI■■.I C/ '" * tri e ✓•' �� Q� ✓ u — ■■■■EMOM �-®®.. T ■ 101 ■■■ :nsion `� �'" - ' ✓1 Ext. Walls Interior Finish r~ ■■■■■ME5MM®■■■E■■■■_ Bld `''`� �d Foundation /E'%E', Bath :nsion '' �' �. ; �`a j,�_ Basement n . f ��. Floors f ~r. . C/ '" * tri e ✓•' �� Q� ✓ u — :7 :nsion `� �'" - ' ✓1 Ext. Walls Interior Finish r~ :nsion Fire Place Heoit O r' Porch Attic Porch Rooms 1st Floor .zeway Patio Rooms 2nd Floor age �� 1 6 - Driveway Y Town of Southold LWRP CONSISTENCY ASSESSMENT FORiVI A. INSTRUCTIONS All applicants for permits'` including Town of Southold agencies; shall complete this CCAF for proposed actions that are subiect 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. *E,YCe1Jt ininor exelllp!- aC6017S inchtdhl Bllildil7c' Perinits 011d other 117i77iste7.iG1pe771111S 1101 10CClted ii4thin the Coastal Erosion I-Ia. nrd 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 The Application has been submitted to (check appropriate response): Town Board � Planning Dept. I Building Dept. Board of TrusteesVS Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: ct Location of action: Site acreage: Present land use: -T tt : -rte- �i ��✓�t.t' �_'��%1� - t�. r Present zoning class ificatlon:__4 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:'�G: (b) Mailing address:_/4/) (c) Telephone number: Area Code - t, ;�-• 1,-d-i.�-t (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ❑ No N 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 r Attach additional sheets 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 NLNot Applicable Attach additional sheets ifnecessary 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 E No Not Applicable 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 i Yes 0 No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III — Policies Pages 16 through 21 for evaluation criteria N ot 0 Yes 0 No L4NI-Not Applicable 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. FP,Yes Not Applicable Attach additional sheets if necessary Policy %. Protect and improve air quality in the Town of Southold. Sce LWRP Section III — Policies Pages 32 tltrough 34 for evahtation criteria. l ❑ Yes [:,]No ` Not Applicable 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. ❑ Yes ❑ No N Not Applicable 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 ' NNot Applicable 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 tlirougli 56 for evaluation criteria. ❑ Yes ❑ No ;,I, Not Applicable Attach additional sheets if necessar% Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconzc Estuary and Town, waters. See LWRP Section III — Policies; Pages 57 tlzz•ough 62 for evaluation criteria. Yes ❑ No LN Not Applicable r 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 N� Not Applicable 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 P. Not Applicable f Created on. 5125105 11:20 AM 617.20 Appendix B Short Environnientrrl Assessment Form Illstructiolls for CoIllpleting Part 1 - Project Information. The applicant or project sponsor is responsible for the completion of fart 1. Responses become part of the application, for approval or funding, are subject to public review, and n:ay be subject to further verification. Complete Part I based on information currently available. If aciditionai research or investigation would be needed to fully respond to any item, please answeras 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, d fir, p Name of Action or Project: Project Location (describe, and attach a location map): Brief Description of Proposed Action: Name of Applicant or Sponsor: Telephone:r�j� 8 E -Mail: ~•J� Address: City/PO State: Zip9p C��o/'de: j g�s� qq jj Q( 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 finding from any other governmental Agency? NO YES If Yes, list agency(s) name and permit or M)roval: i 3.a. Total acreage of the site of the proposed action? acres b. Total acreage to be physically disturbed? 9 i acres c. Total acreage (project site and any contiguous properties) owned- wned or or controlled by the applicant or project sponsor? 3"j acres 4. Check all land uses that occur on, adjoining and hear the proposed action. z ❑ Urban ❑ Rural (non-a"'ricultu e) Ei Industrial n Commercial 'V -Residential (suburban) El Forest u Agriculture ❑ Aquatic ❑ Other (specify): Parkland i Page I of 4 Is the proposed action, NO a. A permitted use under the zoning regulations" i i b. Consistent with the adopted comprehensive plan? YES � 6. Is the proposed action consistent with the predominant character of the existing built or natural lardsca;�e? y N0 YES t f 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? If Yes, identif}': NO I'ES i S. a. Will the proposed action result it: a substantial increase in traffic above present levels? b. Are public transportation service(s) available at or near the site ofthe proposed action? c. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? NO YES L 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: NO YES Y, 10. Will the proposed action connect to an existing public/private water supply? If No, describe method for providing potable water: NO YES j 11. Will the proposed action connect to existing wastewater utilities? If No, describe method for providing wastewater treatment: NO YES 12. a. Does the site contain a stricture 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? 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 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 ❑ Agri cultilral/grasslands ❑ Early mid-successional ❑ Wetland ❑ Urban TrI Suburban 9 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? 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? 9 NO ❑YES, b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe: ❑ NO YES NO YES NO YES Pagc 2 of 4 IS. Does the proposed action include construction or other activities that result in the inbpouncinhert of water or other liquids (e.g. retention pond, waste lagoon, daub)? i If Yes, explain purpose and size: ( NO -v i YIiS small to large I impact 19. F-Ias the site of the proposed aC[t011 Or an acijoinhhg property been the location of an active or closed solid waste management facility? If Yes, describe: i \O ; 1, ES j j -- occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will tlbe proposed action result in a change in the use or intensity of use of land? 20. Has the site of the proposed action or an aciiouung property been the subject of remediation (ongoing or completed) for hazardous waste.) If Yes, describe: NO } YES 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 I AFFIRM THAT THE INFOR`'IATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY I{hvOWLEDGE Applicant/sponsorif4r: ); XJ 'J V'Le JU Date: -7 Signature: �, t %°moi/ , J / d 't - Part 2 -ZIPZ�S�C2ment. Th cad /Aency 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? 2. Will tlbe proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 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? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate 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? S. Will the proposed action impair the character or quality of important historic,.archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources (e.g., wetlands, waterbodies. groundwater, an' gUahty, 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 inay occur". or if there is a need to explain wily 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, longi term and y cumulative impacts. 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. El 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. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (if different from Responsible Officer) Page 4 of 4 No, or i Moderate shall to large impact impact may may occlll, I occur 10. Will the proposed action result III all increase in the Uotelltic^.1 f01' c'1'Os1011, tlo0dlllg Or drainageproblems? 1 1. NVill the proposed action create a hazard to envi-onn rental 1'esolll'ces of hllliial. hC<.ltll? 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 inay occur". or if there is a need to explain wily 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, longi term and y cumulative impacts. 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. El 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. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (if different from Responsible Officer) Page 4 of 4 NORTHEAST ELEVATION 4 4 9 q O EN04 N O 1 {4 NORTHWEST ELEVATION VERIFY ALL DOOR, WINDOW, SKYLIGHT AND SIDELIGHT LOCATIONS WITH THE OWNER. r¢— R 4 4 R R 0 'p _N N b N M 1 CV SOUTHEAST ELEVATION Oco O o m 1 00 SOUTHWEST ELEVATION SHINGLE OVER VENT -A -RIDGE (Dw SHINGLES 5" O.G. GUTTERS CEDAR SHINGLE SIDING T#150 DRIP EDGE CEDAR SHINGLE SIDING DRAWN BY.• 'MB DA TE: • 11 /3/2014 CHECKED BY.' SAM C DATE. 11/17/2014 REVISED DATE: — REVISED DATE.• — REVISED DATE.' — EVISED DA TE: I — F: yP •'�O SUrT• * g 6' d 44.5n�9Z a�F IIe ��hnc.•w �Pa�� SCALE: AS NOTED 2' B' SCALE: _ SHEET NO. 1 4' 16' S4 OF S7 OffICE.• DESIGN AND EXPLANATORY ''NOTES CurcrlocuE, NY JOB NO. 1.) EXTERIOR DOOR AND WINDOW LOCATIONS ARE TAKEN FROM THE EXTERIOR FACE 128-045059 OF THE NAILERS AND ARE TO THE CENTER OF THE DOOR AND WINDOW UNITS. VERIFY ALL DOOR, WINDOW, SKYLIGHT AND SIDELIGHT LOCATIONS WITH THE OWNER. r¢— R 4 4 R R 0 'p _N N b N M 1 CV SOUTHEAST ELEVATION Oco O o m 1 00 SOUTHWEST ELEVATION SHINGLE OVER VENT -A -RIDGE (Dw SHINGLES 5" O.G. GUTTERS CEDAR SHINGLE SIDING T#150 DRIP EDGE CEDAR SHINGLE SIDING DRAWN BY.• 'MB DA TE: • 11 /3/2014 CHECKED BY.' SAM C DATE. 11/17/2014 REVISED DATE: — REVISED DATE.• — REVISED DATE.' — EVISED DA TE: I — F: yP •'�O SUrT• * g 6' d 44.5n�9Z a�F IIe ��hnc.•w �Pa�� SCALE: AS NOTED 2' B' SCALE: _ SHEET NO. 1 4' 16' S4 OF S7 a No: 36300 Town of Southold Annex 54375 Main Road Southold, New York 11971 6/17/2013 FRE EXISTING CERTIFICATE OF OCCUPANCY Date: 6/17/2013 THIS CERTIFIES that the structure(s) located at: SCTM #: 473889 Sec/Block/Lot: 805 Aborn Ln, Cutchogue 118.-6-1.1 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 36300 dated 6/17/2013 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame one family dwelling with screened, porch and brick patio.* The certificate is issued to Hohn, Janet of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Authori . Sign tune s BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 805 Aborn Ln, Cutchogue SUFF. CO. TAX MAP NO.: 118.-6-1.1 SUBDIVISION: NAME OF OWNER(S): Hohn, Janet OCCUPANCY: ADMITTED BY: Erick Heins SOURCE OF REQUEST: Hohn, Janet DWELLING: # STORIES: 1 # EXITS: - 3 FOUNDATION: cement block BATHROOM(S): 2 TOILET ROOM(S): PORCH TYPE: screened porch DECK TYPE: BREEZEWAY: FIREPLACE: DOMESTIC HOTWATER: yes TYPE HEATER: TYPE HEAT: oil WARM AIR: x # BEDROOMS: 4 # KITCHENS: 1 OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST: SWIMMING POOL: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: RYF DATE: 6/17/2013 CELLAR: 1/4 CRAWL SPACE: 3/4 1 UTILITY ROOM(S): PATIO TYPE: brick 1 GARAGE: propane AIR CONDITIONING: yes HOT WATER: BASEMENT TYPE: unfinished STORAGE, TYPE OF CONST: GUEST, TYPE OF CONST: DATE OF INSPECTION: 5/1/2013 TIME START: 09:30 AM END: 10:30 AM , is •i7- S � f` n¢K*. jr. h_ .,};,:'-�i. �i'�`h: �..5 Z� t^r4'ad.7r.`'�'����A^.�.'�4+ � • �'-'Pnca-A1E' E � Fl moss 10C)0 ll R � SEE SEG. 111 11 — LINE m ` 3.6 a I � 11 _- pot rc* _ neweta a _.. 19.8A(c) _ p,zE - _ o OV a 'end '1 - 15.1 OFA a _ TOWN OF a.q � 1.Sq -' - v - �- te'10 •� -' (� 9 SOUTHOLD •� a 3 a? 18.3 'g 2 t' g �` • o gs� ` 1.TA(c) = , ' zea •+O aos Y s f� •O O $ - 0 `� 4 ��.,; � - m 5 .b• D 5 u n'm S•• � `' � � •ns � 51 a cw 3 mn �w 8 16.1 % ,� ` J' •Yw P�+ p -•I ZOA(c) "�i ^ `s w ^w�Pl 'R'pP�, p .s• 42 �b 6.OA(c) a 11.4 10' am "- •asf I -�� '� 13p1c1 ^� �' ;` -�� 11.2A(c) v" n—u m' Lagoon z 46, 01 14 10 i �0 9 W v 7 \� O [T,.4[�TQuw�'yw • jiy�'f,. .• ,�,h-.9✓ !r°r- i 1 �... —Ess wnw+o,Eemmg.aurortRUEs NOTICEcs�l„ OCK.c� COUNTY OF SUFFOLK C O K 111 — — ARE w,kNN+za salaemo tazmxls- E a.N wvmC��j MAIMENANOE ALTERATION SALE OR a Service 5i1 a Property a E Y . ,e — -•„•M,e — s nn � ONO OR NE E Couu,ty Center RT r e 119901 M KN o [T,.4[�TQuw�'yw • jiy�'f,. .• ,�,h-.9✓ !r°r- i 1 �... N I lohm- Iv X66 N I lohm- Iv is � ,yy•yy VrEw FIZ4>A Vt-EV4 Fak-,M NVJ CPOJCe-C'r` .1 s 4 �".�"9 wnz�zwwl .p 0, LEAF-" f j 0 V ' � r, LOT NUMBERS REFER TO MINOR SUBDIVISION MAP OF:a,> HARRY G. do JANET HOHN"FILED IN THE SUFFOLK COUNTY_ CLERK'S OFFICE ON NOVEMBER 25, 1991 AS FILE NO. 9172. RAIN RUNOFF CONTAINMENT: ANY AL7ERA77ON OR ADD1770M TO THIS SURVEY IS A VOLA77ON OF SEC77ON 72090E THE NEW YORK STATE EDUCA77ON LAW. GARAGEG: 2,016 Sq. Ft. EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CER77nCA710NS 2,016 x 0.17 x 1 = 342.7 Cu.Ft. HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF Provide 2 DWs. 8'0 x 5' Deep SAID MAP OR COPIES BEAR 7HE IMPRESSED SEAL OF THE SURVEYOR Connected by Gutters & Leaders •=REBAR SET WHOSE SIGNATURE APPEARS HEREON. i i (tJV:,Y.S. LIC. NO. 49618 GQN�"S� ORS, P. C. ( 31/)`~7 5- 026 FAX (631) 765-1797 P.O. BOX 909 12JO TRA SOUTHOLD, N. VELER 1 971 SMEET 13-,279