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HomeMy WebLinkAbout1000-123.-3-13 /'/�/� pF SO(/T OFFICE LOCATION: ts0 hoV moo; MAILING ADDRESS: Town Hall Annex t P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) • G Q Telephone: 631 765-1938 Southold, NY 11971 P of • COMM,� ' • 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 April 24, 2015 Re: Coastal Consistency Review for ZBA File Ref. JAMES and CAROL SCHERER#6855 SCTM# 1000-123-3-13 JAMES and CAROL SCHERER#6855 - Request for Variance from Article XXII Section 280-116B and the Building Inspector's March 17, 2015 Notice of Disapproval based on an application for building permit for additions and alterations to existing single family dwelling, at; 1) less than the code required bulkhead setback of 75 feet, located at: 1015 Bungalow Lane (adj. to Deep Hole Creek) Mattituck, NY. SCTM#1000-123-3-13 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, the proposed action is recommended as 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 ii.. BOARD MEMBERS Southold Town Hall Leslie Kanes Weisman,Chairperson �s .14 'W SOUjyQI ' 53095 Main Road•P.O.Box 1179 O Southold,NY 11971-0959 Eric Dantest411 Office Location: Gerard P.Goehringer �` & ,� Town Annex/First Floor,Capital One Bank ct•George Horning 54375 Main Road(at Youngs Avenue) Kenneth Schneider =�'YOO fl ' ,,"� Southold,NY 11971 http://southoldtown.northfork.net TOWN OF SOUTHOLD � C E U ZONING BOARD OF APPEALS �_ Tel.(631)765-1809•Fax(631)765-9064 - MAR 2 5 2015 Eli March 25, 2015 Southold Town Planning Board Mark Terry, Principal Planner LWRP Coordinator Planning Board Office Town of Southold Town Hall Annex Southold,NY 11971 Re: ZBA File Ref. No. #6855 — Scherer, James and Carol Dear Mr. Terry: We have received an application for additions and alterations in Mattituck. 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 ruly yours, eslie K. Weisman Chairperson B .1.4t ' Enols. n ' FORM NO. 3 YV5 NOTICE OF DISAPPROVAL DATE:March 17,'11 5 TO: Joan Chambers (Scherer) PoBox49 Southold,NY 11971 Please take notice that your application dated March 9, 2015 For permit for additions and alterations to an existing single family dwelling at Location of property: 1015 Bungalow Lane, Mattituck County Tax Map No. 1000 -Section 123 Block 3 Lot 13 Is returned herewith and disapproved on the following grounds: The proposed construction is not permitted pursuant to Article XXII, Section 280-116B, which states; "All buildings located on lots upon which a bulkhead, concrete wall, riprap or similar structure exists and which are adjacent to tidal water bodies other than sounds shall be set back not less than seventy- five(75) feet from the bulkhead." The . .posed construe ion •o es a - .ck of+1- 19 feet to the existing bulkhead. -,1:" ed S,gnature U - Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Building Department. CC:file, Z.B.A. Fee $ Ftied By: Assignment No APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS AREA VARIANCE House No. 1015 Street Bo to 61<UO U-1 LASE Hamlet M A--CT—CTU C14- SCTM 1000 Section 123 Block 03 Lot(s) (3• Lot Size I(l G 14 L Zone lZ—40 I (WE)APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED (Yl ARCA-- C112olSBASED ON SURVEY/SITE PLAN DATED DEC 26J 2014- Applicant(s)/Owner(s): J MMES c Mailing Address: 2 O kK cS T• S T . �t►'l�S 1� "f j l- 8 O Telephone:63(-332-ki6Fax: Email: VJendic s o1k 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: -... 0 ANS e -M taeR S for Owner( )Other: Address: Tc) 80x- 411. S OUT -k-t aD N-{ Telephone: 631---2"14-- 4244Fax: Email: j Delos t r,'J rS (0 C j tr D. • Ctrs Please check to speck'who you wish correspondence to be mailed to,from the above names: ( )Applicant/Owner(s), kAuthorized Representative, ( ) Other Name/Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN DATED DeC• 2'(' and DENIED AN APPLICATION DATED FEB-(el lS FOR: ,'Building Permit ( ) Certificate of Occupancy ( )Pre-Certificate of Occupancy ( ) 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 the code Article: XX i I Section: �S6— 1 `‘'� Subsection: Type of Appeal. An Appeal is made for: (>4A 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 j has, has not been made at any time with respect to this property, UNDER Appeal No(s). Q-Q /41 Year(s). 13 1 9.8 2— . (Please be sure to research before completing this question or call our office for assistance) Name of Ownet. ZBA Filet/ 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 7.148 FR°poses) . c REQ C.D po R.0 t.k U t t-T c)t -('t-{E C�c�ST'. Eck, T�t� D E c� to.t-. fest o i eE REP C C -to .so p-Po RA-- N• tik.i Roo -t-ttE Cr-- s— s e 71-1; et ©- 1 -I4eptom{-to©o (,S U 1v CetAl\36-ep• 2 The benefit song it by the applicant CANNOT be achieved by some method feasible for the applicant to pursue,other than an area variance,because: -T-R--e,- a p p Se.p S cam hep EO RCu L.{ U-t _•, BE. $dtL t OI\. TOi OF. `t om d✓2c(5T. A-t t IkC teb D cC4 LAJRlCif C Af'(SOT $ CA-Th-0 T -E DeC1 - tS Exts-17, mouse. 3.The amount of relief requested is not substantial because: .- ,E S ,O C-cu 6--"G iT-*I nJ -t- Fbc5 Pfd t OF T1-he Esct ST RE5 ID Cry DECK. / JD DD l"(--t a tZAt, Rte+-1 EF tS _ c3DO6-I-F r A-Ds.)ACENT t'RoP�EZ tES t-vsu� S CC \)RES "!IKS C LADS-E, g U L f t-t Ei4 4.The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: Tt�E t i2O QE P_-rif"' i S CON-( tc(N t✓O LA.)// TI,v O But-fi t-(E o S -r N E►A.i K)0-7 eN c e1/4.a/1/4.ck-F 5 Has the alleged difficulty been self created'? { }Yes,or No Why i K t S Ex(S i i rJ - STRO cTURE Are there any Covenants or Restrictions concerning this land? "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 -012C62 .71.-, 1 Signature ,f Applicant or Authorized Agent �`1f (Agent mu. submit written Authorization fiom Owner) Sworn to befo me this�1 qday of ,20 k i I Notary Public CAROL HYDELL NOTARY PUBLIC-STATE OF NEW YORK NO.01HY6189695 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES 06/30/20`t' APPLICANT'S PROJECT DESCRIPTION APPLICANT: lB 4 Ck01-' s - DATE PREPARED: YMA`�CC-{ tq•l 2L�(S 1.For Demolition of Existing Building Areas Please describe areas being removed: NO Demo i-('tk o N) 1-kJ N E D II.New Construction Areas (New Dwelling or New Additions/Extensions): C7Cl5T' Dimensions of first floor extension: N 0 ExTE s i ai.1 - Ttt-k-- aa Dimensions of new second floor: RRQDEels) ft <SCfLfaer3 t3 .9 -to x 25`-0411 • Dimensions of floor above second level: -t-s- Nr .2 2N`" t c • DORme. L . 8--4")c 2.6'7-- Height 6'-Height(from finished ground to top of ridge): C-XiT T - 2('-(U`' N c CRA-1.16-e- lS PRo c®Se-.P- Is basement or lowest floor area being constructed?If yes,please provide height(above ground),measured•from natural existing grade to first floor: NO Bks Er i t i C F. (.51-- Ft.. CO,J. oGTi ot.1 OTttE9---Tt1-7 SO?eb FOt.- DORo\ NS-MOO-rug-I.'. • 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: 1 ! 6 w DQQ • •-Fe,fpm Eft S t N Gly �fkm l L� R'E-s t DEr�G J/• t O_L 2 o O A i i Act—tap UJ 0 op 'D�CtL Number of Floors and Changes WITH Alterations: (5 -FL© - v C,t{-pc -t~S Ve 28i t S+tEO 3)o . Y - kDPED. k57.• PcTC Ctmb DGCt� tA)tt—L `3 p-.o F Eo cS'C2Er. -p F3 UT- 1J CT- E L.Mz6EP • IV. Calculations of building areas and lot coverage(from surveyor): Existing square footage of buildings on your property: 5 E- 'TA-C4-t t3 Proposed increase of building coverage. Square footage of your lot: Percentage of coverage of your lot by building area: V.Purpose of New Construction: -11.) a=N CLO& EX ST tom/ S CRE'eN ctD �f t✓C.S Root= Tfl oLAD /V 1Q3 -1/L-) -C--(-e-r)� 1)0Q_crte ._ .2rdo FL- TD .-Rout De (WO rms ( ►�S rk-i TAG E'D2 S Gi✓ 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): ry‘l(\JC S'LO?e 13La�cTIUd\)S tk (P CA-055—, A' t-L- 0-F 1U �vJ CD S � 7-?U C TO1' s rel p w Tit r r\J te•?<(<Sl(1\ E— i UCTS 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 4 Board of Zoning Appeals Application AUTHORIZATION (Where the Applicant is not the Owner) C72OL ScKE-ex& tOtSS 3u(\)G u0 Lk—NE- residing at (Print property owner's name) (Mailing Address) C do hereby authorize J Ct--KYrke, S (Agent) to apply for variance(s) on my behalf from the Southold Zoning Board of Appeals. rj 7/1„,-/ / rv- • - ((Owner's Signature) (Yl c,0/- SC (Print Owner's Name) ,,,,,,,,,,,,, 0.''eco UL4 n;_ -11 Southold Town Board of Appeals MAIN ROAD- STATE ROAD 25 SOUTHOLD, L.I., N.Y. 11971 TELEPHONE(516)765-1809 ACTION OF THE ZONING BOARD OF APPEALS Appeal No. 2976 Application Dated April 13, 1982 TO: [Appellant(s)] Abigail A. Wickham, Esq. Wickham, Wickham & Bressler, P.C. Main Road, Box 1424 Mattituck, NY 11952 At a Meeting of the Zoning Board of Appeals held on May 7, 1982 the above appeal was considered, and the action indicated below was taken on your [ ] Request for Variance Due to Lack of Access to Property New York Town Law, Section 280-a [ ] Request for Special Exception under the Zoning Ordinance Article , Section • [X] Request for Variance to the Zoning Ordinance Article XI , Section 100-118E [ ] Request for Public Hearing held May 7, 1982: Upon application of Karl and Helen Dimig, 1015 Bungalow Lane, Mattituck, NY for a Variance to the Zoning Ordinance, Article XI, Sec- tion 100-118E for permission to reconstruct and enlarge existing garage located in the frontyard area to an extent exceeding 50% of its fair value. Location of Property: 1015 Bungalow Lane, Mattituck, NY; bounded northeast by Deep Hole Creek; northwest by Smith; southwest by Bungalow Lane; southeast by McCormack; County Tax Map No. 1000-123-3-13. The board made the following findings and determination: By this appeal, applicants seek permission to enlarge an accessory storage building located in the frontyard from its present size of 12' by 20' to 23' by 26' , requesting a setback from the southerly side property line at three feet. The premises in question has constructed thereon a private one-family one-story frame dwelling and the accessory building in question. The driveway to the subject dwelling runs generally along the north side of the accessory building. The area along the southerly property line is wooded. It is the opinion of the board that the project proposed is reasonable under the circum- stances, however there should be a setback from the southeast side property line no closer than feet feet. In considering this appeal, the board determines that the variance request is not substantial in relation to the code require- ments; that the circumstances herein are unique; that by allowing the variance no' substantial detriment to adjoining properties would be created; that the difficulty cannot be obviated by a method, feasible to appellant(s) , other than a variance; that no adverse effects will be produced on available governmental facilities of any increased population; that the relief requested will be in har- mony with and promote the general purposes of zoning; and that the interests of justice will be served by allowing the variance as applied for and as specified below. On motion by Mr. Grigonis, seconded by Mr. Douglass, it was RESOLVED, that the application of Karl and Helen Dimig for (CONTINUED ON REVERSE SIDE HEREOF) DATED: May 18, 1982 CHAIRMAN, SOUTHOLD TOWN ZONING BOARD OF APPEALS Form ZB4 (rev. 12/81) 0 9 Page 2 - Appeal No. 2976 Matter of Karl and Helen Dimig Decision Rendered 'May 7, 1982 permission to enlarge garage located in the frontyard area, Appeal No-. 2976, be and, hereby is GRANTED, SUBJECT TO THE FOLLOWING CON- DITION: That the garage be constructed no closer than five feet to the southeast sideyard line. Location of Property: 1015 Bungalow Lane, Mattituck,. NY; County Tax Map Parcel No. 1000-123-3-13. ' Vote of the Board: Ayes: Messrs. Goehringer, Doyen, Grigonis and Douglass. (Member Sawicki was absent.) APPROVED/ AZ: / 4141631-7411111111111, RECEIVED AND FILED BY THE SOUTHOLD TOWN CLERIC DATES/ig HOUR a '94011 Town Clerk, Town—cd :uthold 3G FORIV1 NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z +ooh Date ;rep: 29 , 19.7:Q.. THIS CERTIFIES that the building located at .E./S...Bunga11W,..La Street Map No. .xx Block No. Lot No. .XIC........PiAttn.144N•*t,t conforms ,substantially to the Application for Building Permit heretofore filed in this office dated Oct 28 , 1969..., pursuant to which Building Permit No. .. 5.2. .x.. dated £Gt 28 , 19.69.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which -this certificate is issued is Pr.3.vate..,an...f mit 7 y..t7.ie. .tg........1..r.e,placezent. .4?t. .0 4st (hwo-z) The certificate is issued to ... a.ig•..Diin ,g Owner (owner, lessee or tenant) of the aforesaid building NOTE: 2nd floor unfinishedat this time House # 1015 6{, ( (i < < Building inspector I t u-9 • FORM NO.2 ,TOWN OP SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4528 Z Dote ....2i ..., 19.. 9. Permission is hereby granted to: • etittbosissk to aft , at premises located at , PiM , ..XittiMa Ott*** /#1 pursuant to application dated ikeit 19..6, and approved by the Building Inspector. Fee $10440 411/44 etABuilding Inspector • ,?, ..)1P ., TOWN OF SOUTHOLD 417/" f t,/.r IA( , BUILDING DEPARTMENT fr, k(i- r- 0,,is TOWN CLERK'S OFFICE /44v. , K.,a, O,1/.< f `'—� O //} SOUTHOLD,N. Y. .0.0.(ded) , 19b.7... Li, .aT�e d� �f 8--,J0-... .4t- A.-em.,...., Examined z �c Appllccgqtion No. . ,r.7 �3 Approved it q 4, .. �C/ Z— 7� n a+za 47.....4-- Approved L� 19 Permit No. 741/70cerv, i--. Disapproved a/c aM ? (Building Inspector) d - ,..„-- No t-i , 4ig�7v ' .(� i O ,-, APPLICATION FOR BUILDING PERMIT /� o ,.... - Date QQ QtigK ?fi , 19 69 O:Tcv INSTRUCTIONS ` _ i St-.•7 r 0e a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Z Inspector. b. Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas,and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. r c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 1 APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Y Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings,additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. _ Wm. Beebe , (Signature of applicant,or name, if a corporation) —7Cutchogue (Address of applicant) State whether applicant is owner, lessee, agent,architect, engineer, general contractor, electrician, plumber or builder. - Contractor Name of owner of premises Karl Dimig If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) /1 I Location of land on which proposed work will be done Mop No XX Lot No• 11X /0 /S Street and Number . 8 8ungalow..T•anQ Mattituck Municipality 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vacant land b. Intended use and occupancy pfe„ apl1ly...S�w.11-.1n-$ J Nature of work (check which applicable): New Building XXXI Addition Alteration Repair Removal Demolition Other Work (Describe) 4. Estimated Cost Utak. Fee 1Q..QQ (to be paid on filing this application) 5. If dwelling, number of dwelling units ......one. Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures,if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front 31+ + Rear4 � Depth....26 4' Height Number of Stories one 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated ......1.1a4" dist 12. Does proposed construction violate any zoning law, ordinance or regulation? ..........7:1,Q 13. Name of Owner of premises Karl DimiZ Address Phone No. Name of Architect Address Wm Beebe Phone No. CU.tChoguG Nome of Contractor Address Phone No. • PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. C) — V /04,_. h /6 ., y . k\ I c 11 Cs-.\ 3J 5'w+- 6,1-,- AIt— STATE OF N Y RK COUNTY OFUA1 f SS. Jim.....B.eehe being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ,Conractor (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and fife this application; that all statements contained in this application ore true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this 28... day of OC t (�/�f r (V&A Notary Public, 19...6.9. �i� , ����� , �'/f�2/2 _-", only 5,402,24 (Signature of applicant) ELf2ABETu ANN NEVILLE NOTARY PUB11C, State of New York No 52-81p5s50, Suffolk County Term Expires March 30, 19 ? FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. 74922 Date Oct 1 19...[.0. THIS CERTIFIES that the building located at EIS Bungalow Lane Street Map No grog Block No. g........... Lot Nom Hattituok....�I.�G. conforms substantially to the Application for Building Permit heretofore filed in this office dated Aug... 22 , 19.69.. pursuant to which Building Permit No. .4429Z... dated Lug 22 , 19..69., was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is Privet...garaga (aoaasaor z..B1dg) The certificate is issued to ..Xarl..Dimig Owner (owner, lessee or tenant) of the aforesaid building. House # 1015 c� Building Inspecto 3 -Ir FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy No. .Z.1.1.090 Date J1.4y. .40. . . . _ , 19 &2 THIS CERTIFIES that the building Location of Property . .1015 ?ungalow Lane Mattituck Hors No. Street Hamlet County Tax Map No. 1000 Section 1.43 Block 03 Lot 013 Subdivision X Filed Map No. X Lot No. X conforms substantially to the Application for Building'Permit heretofore filed in this office dated . .Marsh.29 :, 19 82 pursuant to which Building Permit No. 11656 Z dated May 12 19?. . ,was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is t.Wtorca.r. .8arAggi. sec9pd floor storage. The certificate is issued to 440. & He l e n (ovw►er,keMweoremend of the aforesaid building. Suffolk County Department of Health Approval n/a UNDERWRITERS CERTIFICATE NO n/a dJ 1/ t :uilding Inspector Rw.1/81 - i , 1 • TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY,:::t1971 -, ) _• }'... ._" .,A,' I •-, ;,1; . 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX:_(631)765-9502 j: ' ._:•:,_r, .• ,f\ , • .:., • • . :P, , Survey SoutholdTown.NortlhFork.net,:.. ..PERMIT NO... :• • k , Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20 Single&Separate • ` : . Storm-Water Assessment Form }1a,c1 , (' i__ nn ,^ H Approved ,20 ' �c /‘(' til uI 1�� . ^, 1 ► �� Disapproved a/c _ / ' 1 MMI ' ' • ' ' '(7-Th ' lime:-9 2915 '-1) id/((— ' YI Exp - ' _ $ � i _l _� C BLDG.DEFT j '_<1 ;; , B • uilding Inspec t` TONIN OF SOUTHOLD • .. ILi 8 .201 • 1 -' , APPLI7.CATION FOR BUILDING PERMIT 4 1 -r• Date FE$•_ fo , 20 bS �:n•.- ' )a 1 APPR V,1:. • 'UCTIONS .. ... a.'This application►MUST.be conipletelyifillei in by typewriter or in ink and submitted to'the'Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of-buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. 1 c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprdval lof this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No'building shall be occupied or used in whole or in part for any purpose•what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every' building permit shall expire•if the,work authorized has not corijmenced within 12 months after the date of issuance or has not been completed within 18 months froth'such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim,the,Building Inspector may authorize; in vrijing,the:etension of the permit for an addition six months. Thereafter,a new permit shall.be'required. , ' . : .� APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,New York,and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances,building code,housing code,and regulations,and to admit authorized inspectors on premises and in building for necessary inspections. ( i ature of applicant or name,if a corporation) TO •8 O 4R . 600-c ac-,l, N " (Mailing address of applicant) k kot,1,j State whether applicant lis owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder - Name of owner of premises TA rnFS 4 CA-R.01. 8 Gl{—e—gECS • . ... .ray (As on the tax roll or latest deed)''' If applicant is a corporation, signature of duly authorized officer • ,. _ ,f', (Name and title of corporate officer) _ Builders License No. Plumbers License No. Electricians Lidtnse No. Other Trade's License No. 1. Location of land on which proposed work will be done: 101 S 1u NI G-�tiO J L * " (M k-C-T17 L.,c,. . House Number Street Hamlet • County Tax Map No; 1000 Section 1'2-' 3 Block 0 3 Lot 0 1 3 1A— M ter, • �,ftTOo1'Pc&t4.- Subdivision Filed Map No. t 9 Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy S G-Le. L'- �2�5 LD ENS C, b. Intended use and occupancySAME ^ WtkPD SGR et RDoc- TD E?ct.ST D trCK OR(\ Com. 2No •QLooC•�. 3. Nature of work(check which applicable):New Building Addition Alteration ✓ Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units I Number of dwelling units on each floor N Pic If garage, number of cars n1 Ps 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.'' N A- 1 r 7. Dimensions of exi ft sttuctt11 $ if any: Front 26.3 Rear 34. 3 Depth 31 'O Height 22.1-O' Number of Stories Dimensions of same structure with alterations or additions: Front 2.(o(3 Rear 34, 3 Depth 3 7.0' Height 2.2'-o" Number of Stories SIM PoRrnaz, Et��2 281 S k P NO; tests-t-trckto+•s 8. Dimensions of entire new construction: Front NA Rear DoRrne-R-- Depth Ni Height NA- Number of Stories NA- 2-" - Roc c ovet'. 9. Size of lot: Front 3l• DLJ Rear S 3 ` (07 � 'D7' th l� Qr 'r 2�i,�.4' v��. 10. Date of Purchase 2,0\A" Name of Former Owner l"ArR•t✓ 4 /J rn t 6- 11. Zone or use district in which premises are situated R- 4D 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X 13. Will lot be re-graded? YES NO )4. Will excess fill be removed from premises? YES NO X J krAE55 et. CARO V 14. Names of Owner of premises SGA - Address ST c 1111.1Wis• Phone No. .3(332-GDI 9 Name of Architect Address N`I t l'1-8r) Phone No Name of Coutiactor JoAt'J C4- (r8 -S Address f0 $ox Phone No. fo3(-2`t4-42-41 Amt' so" t L-D ray tL 1 t I 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES ✓ NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS Y BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES V NO * IF YES, D.E.C.PERMITS MAY BE REQUIRED. 16. Provide survey, to scale„with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data Ion survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO ✓ '* IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: , COUNTY OF S Tom c 1/4�'Ms being duly sworn,'depose's and `says tat(s)he is the applicant (Name of individual signing contract)above named, (S)He is the { (Contractor,Agent, Corporate Officer,etc.) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swornbefore me this ,� day of f-.--do20,. S Notary Public VICKI T0TH , S ature of Applicant Notary Public,State of New York • d No.01`f06190696 Qualified in Suffolk County Commission Expires July 28,20A1 Q <* `. .-,,,- .0 r ; . , . SCHERER RESIDENCE , �. `_ EAST ELEVATION - -� SCHERER RESIDENCE ,r. 7�t p, (LOOKING SOUTH-WEST) ., EAST ELEVATION DECEMBER 2014 i (LOOKING NORTH) 4 �� ck 4 r i' w r ' ''i rill. A ',? ••'`--."';''''......-......,...-_:,.:,.,F....„,..,_,, -:.,:,-'.,,,,-,---7--z-7,,,,;;,..;,,,.::,,• .,,..ii ...%4 . . i 4 ' 1 f'' rials i ii 11i ■ �" $�� `�,! .. ~, ,'" q N � .. , a• . • • n K a''4A"{',+••,,,,"4.-.',, ..1''!" r J "v 4 � ....1 .� ' ua. 1Y,Hr- 3:S.‘1,•• moi- le,..„.-: .` '. ,Ysd p;'-',v, a of ,t. 4, ' `^+:•. ,.,,,,.‘,01,4:044 '+6 'in m ,z,•,..1' . e' `;� � �,C`t iia s 'x SCHERER RESIDENCE .'"k i'' SCHERER RESIDENCE rr � '', '>.: EAST ELEVATION y ,- �•_ . F , WEST ELEVATION a . ° DECEMBER 2014 j` (FRONT) r DECEMBER 2014 it'' V.► �` %. l • A a. c' f •_ ,.- t' v PROPOSED DORMER \ ' '-' nc Tslc .+.° �� ON THIS SIDE OF ROOF /.' x S" A ,1.. . ,. 4. '''' ;Iffi ' ' ;?..„:::'- , i' - - .- I ' :old' wr -� . . PROPOSED RO REE ED PAN 10'''.':4*.' �`' . tta4 + � 9, THiS DECK iii �'r 9 ,•rr "1i ':a*. m, ....emit �:. k ,,,yh, r • •r :r. :1 AIM r Al rl r-,}�` h• 'I ke,:C,'E,10 ,Z 1" 1ir' 1; " 0 r,'° , •, ....,.•«x—�.� w " fir, *J MP. i V 10 * v 6Nid1H i., � d. T) Witt riat{bi. • •''..W t a'0bw `S.y wv - . i G.i - �,r.... .- [y ... n' a y SMF ....._. 5 C e(2-- KE' t DMce /10 8on1E tox/tl ill E / D EC e 2 - 4-` P6. - SCHERER RESIDENCE 1; / ..1, -' �" �i SOUTH ELEVATION • / SCHERER RESIDENCE 4 ', + DECEMBER 2014 ?`; NORTH ELEVATION �'} • DECEMBER 2014 ' ,., 4 ...:.__.7....,,,..7..,, ,...,' '141IN 1 1' '� ' ;• ` ---- ,.....1,5....4.:....„.:„. ......„„:.:,... •.';;;.‘43'''''' . r - _,.,.... '' .'".7,1" L T ��• 1!'il'i 1 III ill In• 1UP Y '�,r, i ff 0 r `1\ \, �� � n Jss i.t .17-4,-:5..-.;,., r� /- . , fF r �r f Jp i `` 'i• ,4w ' , A 11 XI's gD • .,� �i �i' r i, *,f,,_._,'' SCHERER RESIDENCE + SCHERER RESIDENCE Eti t SOUTH ELEVATION AST ELEVATION DECEMBER 2014 , LOOKING NORTH @ NEIGHBOR'S HOUSE • DECEMBER 2014 1 .ter +ex-: ., f •,j 7 ( rte �y, i•'r I � Li R M r � e I / / ' •1 ;fir •, ♦ � . r • /may y ry¢is • 1-` q"„ • ci RE,S( cie7 i 0 is 8 u rc-0 w Likl`l E / i) ernG-�2. 2-Z3 t4 P _ 'L APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM - The Town of Southold's Code of Ethics prohibits conflicts of intereston the part of town officers and employees.The purpose of this form is to provide information wliich can alert the town of'possible conflicts of interest anti allow it to takewliafever';' - action is necessary,to'avoid same. YOUR NAME: t V c Ct\F t (Last name,first name,middle initial;unless you•are applying in the name of someone else or other entity,such as a company.Ilse,indicate the other person's'or company's name.) , • TYPE OF APPLICATION: (Check all that apply) _ Tax grievance / Building Permit Variance Ni/ Trustee Permit 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 the town officer or employee owns more than 5%of the shares. , `' YES NO V 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 • SSignSubmitted this )1. day)of `( ,20 1.15— Signature ature J � I("Yl �c t ""t E� Print Name 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 w it to take whatever action is necessary to avoid same. YOUR NAME: C 4 j�-O L C t0 52- (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance Trustee Permit 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 the town officer or employee owns more than 5%of the shares. t / 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 ICL day of I)'l r lZat,20 I c Signature C{ h /7 ,i •(�t 11? Print Name C kg-0 b AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts:of interest onstlie'part of town,officers and:emploveek,The purpose of this form is to provide;information which canualert,the town ofpossible conflicts of interest and'allow itto`.take whatever action is'necessary.to avoid-same. YOUR NAME: r C frcra13 -s' • (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance i/ Trustee Permit 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 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)thelegal 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 1t- day of M-ARGt+,20 V Signature !e Print Name U ()VW QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION A Is the subject premise)s listed on the real estate market for sale? Yes V No B. Are 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? I L S 2.)Are those areas shown on the survey submitted with this application? N 0 3.)Is the property bulk headed between the wetlands area and the upland building area? 4.)If your property contains wetlands or pond areas,have you contacted the Office of the Town trustees for its determination of jurisdiction? `iES Please confirm status of your inquiry or application with the Trustees. 1 Or r'. S i Pc-t-W c P&RM (7ENo(ry 6 and if issued,please attach copies of permit with conditions and approved survey zt3A AFPaev't D Ts there a depression or sloping elevation near the area of proposed construction at or below five feet above mean sea level? N)0 E. Are there any patios,concrete barriers,bulkheads or fences that exist that are not shown on the survey that you are submitting? i\.)0 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 tune concerning your premises? N 0 If yes,please submit a copy of your building permit and survey as approved by the Building Department and please describe. Nl 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 / 7cCt-k&A H. Do you or any co-owner also own other land adjoining or close to this parcel? N)+ If yes,please label the proximity of your lands on your survey. T. Please list present use or operations conducted at this parcelESS L• SL ekrn 1 t—`t RCS - / kT1.7cC- t 9 wand the proposed use Skrnc poe_ctA OrJ eCK- J ftp DO R r nEg.._ 0(S (ex existing single family,proposed same with garage,pool of other) i Authorize signature and Date AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS TOWN OF SOUTHOLD WHEN TO USE THIS FORM: This form must be completed by the applicantfor any-special use permits 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. A'Y\-cS 4 ck-RDL, CSC:I'(zez-«/TOICYJ CKArneers' �-&& 2 Address of Applicant: 1 t7 15 U N)GL.0 W t–htJ El ryl TT(TU C( -• 3. Name of Land Owner(if other than Applicant): S fmn 4. Address of Land Owner: LOlS 6' VN6AlLUut; /A-1%X; 5 Description of Proposed Project: /EDO 6Cee P FANeL 4 RUOP q1D e,<(Ze. DECD 4 kc ' S'L-h o D2+n. Z DEN\SC€ • 6. Location of Property (road and Tax map number) (O1 5 01\16-/cL0 Lik\f>✓ if fl - ( t ZTUCK (ODS —('Z3 1 n3-- ( 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 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 2 3. 4. - 5. 6 (Please use the back of this page if there are additional property owners) /q /tweet/ ZOOLS-- Signature S`Signature Df Applicant Date Li Note I 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 7 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 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# 12-3 - 03 - (3 The Application has been submitted to(check appropriate response): Town Board Planning Dept. H Building Dept. Board of Trustees ig 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e g. capital H-1 construction, planning activity,agency regulation, land transaction) I J1 (b) Financial assistance(e g. grant, loan,subsidy) • (c) Permit, approval, license,certification: Nature and extent of action. -TO ADD S C R EES k \&L S `t A I DO A !d axis-rime- '21 3 iJj U3 DOD DECD — IQ 0 eNt kKC-e r E f k 00 /r S D Do R.nne2. riacrykt LH D C• . Location of action: 1 O 15- B.Lj NI 6-/1/41,0 uki t-kr S E,/ T1TU C K Site acreage: 0 x 3 8 3 Present land use: S 1etFft--m t R E,S(S7 t✓a1fT 1A(-- Present ✓Present zoning classification: y— 4-b 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: . --0A-7\J C YI.� _ (���- r prj(< D N K.J (b) Mailing address: ?o BOX_ 4 et SO U Two L. 2 N (c) Telephone number: Area Code( ) 0 31 — 2°L4 — 4 2_4 ( • (d) Application number, if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes Nog 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 xi Not Applicable No P 20PO5EQ C- RAc S. 0 F R_ESt D (A(__ Corn W N t-1`( -- CR E c eo �a fit S _Doom- S CCrrirYioN k-Z A . tNc Ac v ERSG ITS a P D moo? m4ry i Ac2.E. tet PA-c- i3 c s E 1Th -E 0 E f 3 L A &EM c7 F E L T . ser U Cis; 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 1 Yes El No KNot Applicable KID (C i-to u S 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 Ri Yes r No r, Not Applicable ?RoF'05o itJ e 4 Rooms Drs s T• ALTTveto CcK_ W (LA- Be BEL ouw Ex(ST• RLoEB LrN Ot= . <c(sT- •• .► ` u- .: • * • ,?e L-A N OS C 7k-f)-a fS kM T tc t PAT-ED • 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 `d Yes No y Not Applicable e X LLS'T - S T2 u cTU 2-E-,S W N o i 5'-e- f E -Lo c, o f� N Lit L.te--l-t- CSS VJ i t .L- N O T fit-%TE • 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 k Yes El No El Not Applicable 'BOOP- P-O IJ -O tU i L-L_. BE Root/Q ck CONTSt N eP l/V k e P it G (P 2t W-G l,l-S. Se-E- mimic-C tte.Q 'PLAN' • 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. Sec LWRP Section III-Policies; Pages 22 through 32 for evaluation criteria. r, Yes E No `y Not Applicable ?RoeoS A L. -7(ot.) -TD - ?c t5 i s��u cru (p EC. e Roar) S L- rJ DLUk0 3 tS T_ E u i-V--- -%E A . MO -TX)-E--06--(1\36--( 'l`t LL t Act-- C> F L! cG T r c t,1 t S A-S ?SRT OF 1t-LS ‘ZE ci- • /o Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. Yes H Noir Not Applicable o� CT t!JvE NO ttv\P)cCT e c(t 11-- Attach QU LX (Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes.lSee LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ' I te Yes No �'` Not Applicable (2DjccT vi L-L- JE kW) i rnPkCT O3 3L-( D iwAs tE . 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. H Ye, No kr Not Applicable N)C 1-DS i iJ C- EST. C N eQ P kiV DO I N G Dr)F-me-v- CAL, v E- cc'esS D Ose OF 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 No Not Applicable If 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. 71 Yes f I No KNot Applicable fEcS LO E4\-r CT:• 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. Ei Yes No'Not Applicable i 00-C tTh SOO of /6c CUt✓VC. L -Anita 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. r Yes No aiiit Not Applicable Created on 5/25/05 11:20 AM ' (of ��- 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1-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 1 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 3 PCM ES 4 6 o c tet e S`cR,L1 e.to Pa k.C.t- 4 ,bo fZ.C^n c`Z Name of Action or Project. (01. -- By NIC l_a(iJ i,, �, �Vl t ( l-t-uc952- . Project Location(describe,and attach a location map) Brief Description of Proposed Action. RAID `C-(A( c<_D{' V( b J DEEB k-Kbit= C REEi . t Tv (1J S-j 1_L' F:1 ?C>✓D S C ReE ED (SAN-BLS' £ Rt C i ( U I=mo t-c '213 FcDl /c D po mtS(2- Tri t.Si . SiN6L. . REstDeP.1 Name of Applicant or Sponsor ) Telephone co3(_-2f 44 _ 4_2_4..t, �Q C{(�{Yl ��� ( C-� / • E Mail ^ J�Zal Cha ret_ktec•S tO @Inca{ . On , Address Six k°A • City/PO. State' Zip Code. OUT\I-6L-p Gc977 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 s tttvt; ( cwr l13L,,D . DepT• Ft L- 17 2•(o (S- -SO UM-N-49 TbGli J l'R,o Stt=e3 &Prn N;ST2/c[ (u E, PE21r\tT f7 c..1r o 2,f(-)-1.5- 3 G_LS3 a Total acreage of the site of the proposed action'? 0 . 383 acres b Total acreage to be physically disturbed'? 0 acres c. Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor'? Q a j3., acres 4 Check all land uses that occur on,adjoining and near the proposed action. // ❑Urban ural(non-agriculture) 0 Industrial 0 Commercial Residential(suburban) o Forest 0 Agriculture ❑ Aquatic ❑ Other(specify) 0 Parkland Pagel of 4 13 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? X 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO 'YES If Yes,identify. 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b Are public transportation service(s)available at or near the site of the proposed action? x/ c Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action X 9.Does the proposed action meet or exceed the state energy code requirements?, NO YES If the proposed action will exceed requirements,describe design features and technologies. 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: - 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment 12 a Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ><- b Is the proposed action located in an archeological sensitive area? 13 a. Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES 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? x If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres. 14 Identify the typical habitat types that occur on,or are likely to be found on the project site Check all that apply RIShoreline ❑ Forest ❑ Agricultural/grasslands ❑Early mid-successional Aff Wetland ❑Uiban Suburban 15 Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? 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? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? I (NO ❑YES b Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe ❑ NO S:IL-YES c E ,4cIEk OL'E . . DC Page2of4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g retention pond,waste lagoon,dam)? / If Yes,explain purpose and size- x 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe 20 Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGEQ < Applicant/sponsor name (j a i r,,�� r Date: 3 - l - (J Signature: .%%. / 4• , 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?" 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 the 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? h public/private wastewater treatment utilities? 8 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,air quality,flora and fauna)? 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I '� ''86 A N 9;6tL P DISTRICT NO 1000 PROPERTY MAF CONVERSION DATE.Feb 10 2011 x dt.�t '" �: +�"L`#3-'t; r•,. ..r. --17:—...-..i.,..,:-•,-;.:,;;,::,,-.7.;,,:::.4.s,.�.. .:r„,r«; z•,;.iCe::-=, "-i..,a, ..,7 •'