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HomeMy WebLinkAboutNorth Fork United Methodist Church Office Location: �� M � ktirg dclt'e . Town Annex/First Floor,Capital One Bank "" ,R 4 53095 Main Road 54375 Main Road(at Youngs Avenue) P.O. Box 1179 Southold,NY 11971 i � �a"EF Southold,NY 11971-0959 http://southoldtown.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809 Fax(631) 765-9064 MEMO TO: Plannin Board FROM: Leslie K. Weisman, ZBA Chairperson DATE: February 17, 2016 g Boar' SUBJECT: Request for Comments ZBA # 6936 North Fork United Methodist Church The ZBA is reviewing the following application. Enclosed are copies of Building Department's Notice of Disapproval, ZBA application, current map on file. Your review and comments are requested at this time. The file is available for review of additional documentation at your convenience for reference if needed. APPLICANT TAX# ZBA# HEARING CODE DATE OF PREPARER ZONE DATE SECTION STAMPED OF SURVEY DIST SURVEY/SITE PLAN ...... __ w.. ... m North Fork 1000-63- 6936 Ap..ril 7, Art IX Sec Jan. 27, 2016 D&D Harvey United 1-15 2016 280-41(B), Architects Methodist 280-13(B)(2) Church Your comments are requested 1 week prior to hearing date. Thank you. Encls. ZONING BOARD OF APPEALS TOWN OF SOUTHOLD,NEW YORK Phone(631)765-1809 (631)765-9064 APPLICATION FOR SPECIAL EXCEPTION Application No. Date Filed: TO THE ZONING BOARD OF APPEALS, SOUTHOLD,NEW YORK: PP A Licant(s),.•.._..... .�1�TN...... ��CL 1L...m U "�r �� � 40"b !,msl G 4„yN�-�'] . ..... of Parcel Location: House No. Street t (,A,-(& _.••_Hamlet S 0 7-,)40Q) Contact phone numbers:ww-U (°. m„�_._................ �.. . SCTM 1000 Section— 7 Block O/ Lot(s) ��S/ Lot Size,;). Zone District hereby apply to THE ZONING BOARD OF APPEALS for a SPECIAL EXCEPTION in accordance with the ZONING ORDINANCE,ARTICLE J X ,SECTION 766-4/1SUBSECTION ( 6) 51�7E U)(Z) for the following uses and purposes: �o�ssE vF v�raP���P as shown on the attached survey/site plan drawn to scale.Site Plan review 0 IS or[ ]IS NOT required. A. Statement of Ownership and Interest: R M 15 9C-7i_-, y L.L E- is(are)the owner(s)of property known and referred to as q 3 9IT t, 0C P _- ..__1_.___J z/f3 S 0 V'r}-4U� h1 L............. (Hose ax Street,as Hamlet) 3 ,Block _Of ,Lot �� identified on the Suffolk County Tax Maps as District 1000,Section �„ and shown on the attached deed. ] �' bed property was acquired by the owner on t_ The above-described , q q _........ B. The applicant alleges that the approval of this exception would be in harmony with the intent and purpose of said zoning ordinance and that the proposed use conforms to the standards prescribed therefore in said ordinance and would not be detrimental to property or persons in the neighborhood for the following reasons: C. The property which is subject of this application is zoned L W and[ ]is consistent with the use(s)described in the CO(attach copy),or [ ]is not consistent with the CO being furnished herewith for the following reason(s): Kis vacant land. COUNTY OF SUFFOLK) , STATE OF NEW YORK) (Signature) SwornWxe�foc day of��_ 20ota�(N WILLIAM D. MOORE 1w�ceSar�N''�alr9t� '�dati¢rpC @J�3t�,���k '; "44� � ;�4ualiliac�inM'�tat0�rtlk O+�o"�ptlyc .... d ” D��trtrto�i�ai�rrt Ext±xres March 1 b,��6 ZONING BOARD OF APPEALS TOWN OF SOUTHOLD,NEW YORK Phone(631)765-1809 (631)765-9064 APPLICATION FOR SPECIAL EXCEPTION Application No. Date Filed: Page 2 General Standards, please answer the following as it pertains to your project: A. The use will not prevent the orderly and reasonable use of adjacent properties or of properties in adjacent use districts BECAUSE: The subject property is a corner lot which abuts two properties. The property to the east is improved with a medical/professional office campus of buildings with parking. The property to the south has had the development rights extinguished and is in active agricultural production. Neither of these properties will be impacted by the proposed house of worship. The subject property is large enough to accommodate the parking needs generated by the proposed use, and none of the activities on the subject property will have any impact whatsoever on the adjacent properties. B. The use will not prevent the orderly and reasonable use ofpermitted or legally established uses in the district wherein the requested use is located or ofpermitted or legally established uses in adjacent use districts BECAUSE: The proposed house of worship is compatible with the neighboring professional office use. These uses take place primarily indoors and the respective properties have more than sufficient parking for their respective uses. None of the activities associated with the proposed house of worship would have any impact on the adjoining farmland or its uses which are limited to agricultural production. C. The safety, the health, the welfare, the comfort, the convenience or the order of the town will not be adversely affected by the proposed use and its location BECAUSE: The subject property is located on Route 48 in the Limited Business corridor in Southold. Its corner lot location provides safe and sufficient access for ingress and egress to the property for the use as a house of worship with sufficient on site parking. Traffic at the intersection of Horton's Lane and Route 48 is controlled by a traffic signal. There are no adjoining residences and the surrounding properties will not be affected by use of the property as proposed. D. The use will be in harmony with and promote the general purposes and intent of Chapter 280-142 BECAUSE: Houses of worship are recognized as important community institutions. The subject property is well suited for this use and the community will be enhanced by the activities offered at the site. E. The use will be compatible with its surroundings and with the character of the neighborhood and of the community in general,particularly with regard to visibility, scale and overall appearance BECAUSE: The architectural style of the proposed church building is compatible with the "New England" style of this area. The building will occupy less than one half of the permitted lot coverage percentage, and will be situated on the property in a way that is inviting, and which will enhance the view-shed along this portion of County Route 48. F. All proposed structures, equipment and material shall be readily accessible for fire and police protection BECAUSE: The premises are located less than 1 mile from the Southold Fire Department on a primary road system [Horton's Lane and County Route 48] providing ready access to the property. The proposed structures will be build according to the NYS Building and Fire Prevention Code and located on the property with more than sufficient access to all improvements on the property. G. The proposal shall comply with the requirements of Chapter 236, Stormwater Management BECA USE: The property is presently unimproved. Construction will be done in full compliance with all codes and regulations for retention of stormwater runoff both during and after construction is complete. AUTHORIZATION RMB REALTY LLC,a New York limited liability company with offices c/o Marilyn Price, Esq. [Law Offices of Enrico Scarda, PC] 38 Kings Highway, Hauppauge,New York 11788 does hereby authorize the NORTH FORK UNITED METHODIST CHURCH [and its agents]as contract vendee to apply for all municipal approvals [including but not limited to the Southold Town Zoning Board for special exception, Southold Town Planning Board for site plan,and Suffolk County Department of Health Services] necessary to construct a house of worship on the property identified as 43960 County Route 48, Southold,New York [SCTM#1000-63-1-15] RMB REALTY,LLC B X Y Mark Mendelson,Managing Member 617.20 Appendix B Short Environmental Assessment Form Instructions for Comnletin� 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 .. .............. ................ Name of Action or Project: NORTH FORK UNITED METHODIST CHURCH Project Location(describe,and attach a location map): 61-1-15 43960 CR 48 SOUTHOLD Brief Description of Proposed Action: CONSTRUCTION OF HOUSE OF WORSHIP Name of Applicant or Sponsor: Telephone: (631)905-6743 NORTH FORK UNITED METHODIST CHURCH E-Mail: wdmoore@mooreattys.com Address: PO BOX 1286 City/PO: State: Zip Code: CUTCHOGUE NY 11935 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 X 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 NO YES If Yes,list agency(s)name and permit or approval: X Southold Town Planning, Suffolk County Health Dept. 3.a.Total acreage of the site of the proposed action? 2.437 acres b.Total acreage to be physically disturbed? 05- --acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 2.437 acres ....... _...... _ 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban d Rural(non-agriculture) ❑Industrial ❑Commercial ❑Residential(suburban) ❑Forest [J Agriculture ❑Aquatic ❑Other(specify):..._ ❑Parkland Page 1 of 4 ..._... W. _a.�...mm. e. ... ..._....... ���_._w....... .................������ NO 5. Is the proposed action, _YES N/A a.A permitted use under the zoning regulations? X b. Consistent with the adopted comprehensive plan? X 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: X 8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO YES X 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: -Efwerrgy saylri sign MtUres inclu �ncg soar 10.mmmWill the proposed action­ Wconnect to an existing public/private water supply? NOYES If No,describe method for providing potable water:. .............. x .......... ...._..__._....... 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: _on site sanitary system x 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? X b.Is the proposed action located in an archeological sensitive area? X 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? X 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: m IT 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands [B Early mid-successional ❑ Wetland ❑Urban El 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? X 16.Is the project site located in the 100 year flood plain? NO YES X 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? El NO ❑YES X b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: 0 NO❑YES X Page 2 of 4 18.Does the proposed action include construction or other activities thatresultin the impoundment of NO YES P P � � P water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: wr.r 4Vw 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: ...... proposed ___ .J g property J (ongoing_ ...........—d 20.Has the site of the ro osed action or an ad'oininbeen the subject of remediationor NO YES completed)for hazardous waste? If Yes,describe: X I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spo@$01 11 I 6d" # b&(- VN iney H m I's Signature: 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 I 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? b.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)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 1. Will the proposed action create a hazard to environmental resources or human health? L -i Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. ❑ 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. ❑ 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 Pre Name of Res onsi .......� ...... ..... int or Type p ble Officer in Lead Agency Title of Responsible Officer ----_..� y Signature of Responsible Officer in Lead Agency Signature of Preparer (if different from Responsible Officer) Page 4 of 4 QUESTIONNAIRE SPECIAL EXCEPTION FOR FILING WITH YOUR ZBA APPLICATION 1.. Has a determination been made regarding Site Plan review? >� Yes No If no,please inquiry with the ZBA office and if site plan is required,you may apply to the Planning Dept. at the same time so both applications can be reviewed concurrently. 2. Are there any proposals to change or alter land contours? a. _)<' No Yes please explain on attached sheet. 3. Are there areas that contain sand or wetland grasses? tA a. 2.)Are those areas shown on the survey submitted with this .._.. application`? b. 3.)Is the property bulk headed between the wetlands area and the upland building area? c. 4. If your roperhcontains wetlands or pond areas,have you contacted the Office of the Town trustees for its determination of jurisdiction? Please confirm status of your inquiry or application with the trustees: .........._ww ..................... mmm nand if issued,please attach copies of permit with conditions and approved survey. 4. Is there a depression or sloping elevation near the area of proposed construction at or below five feet above mean sea level? AIA O 5. Are there any patios,concrete barriers,bulkheads or fences that exist that are not shown on the survey that you are submitting? 00­Please show area of the structures on a diagram if any exist or state none on the above line. 6. Do you have any construction taking place at this time concerning your premises?_0 0 If yes,please submit a copy of your building permit and survey as approved by the Building Department and please describe: 7. 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 obtain copies of them. 8. Do you or any co-owner also own other land adjoining or close to this parcel? l4 l7 If yes,please label the proximity of your lands on your survey. 9. Please list present use or operations conducted at this parcel VAC A J LA and the proposed use_ ^oar r-- - /-// " (ex:existing single family,proposed:same with ................._..._........ ,garage,pool or other o acant proposed office with apartments above,etc.) A OAio�'riizecd] �tt��� ....�re and Date 49, lir ` . •. � • 4.-Y.a�1 ar1're t.. x wIUANa YM .ra.a.a.a a.NI pi,rmw,�pM....iwX'*.M•.1.Y4.Ya .. CONSULT YOUR LAWYIR 31FORt SIGNING THIS INSTRUAUNT-THIS WSTRUMM SHOULD/I USW W SAWTSAf*My THLSINDENTUIiE.malaths 16thdayol December ,nlneteenhuadredandninety-nine, BETEEN Hark I. Mendelson. 24 tfildberry Court. Cotmmck. hY W 11725 and F0 Renee Polmer. 118 E. Broodway, Port'Jefferson, hY I1777. individually ce on C'onafderatio Dav666iOld.country. as Trustee Or the Rd., tnrden City. %Yru115 0, ansequal ust,, one-third tenants-0-rolmoon, patty of the fist part.and RMB Realty LLC ,.., 24 Wildberry Court Cor=eck. :kd'd 5...—ae m r�. ,. kM i law aM f veer � WITNESSETH thadatlwr I arta orf A,firwt PWin v x oideralfnn of Ten:llallarm and other valuable eonaiderdfon paid by the party of%fir w.vond lure.tf vra hcrthr Arent and relea,e arnto The partly of the aeeond PAIL the heirs m aures.....an a+miFns of titre Purdy of the accwutd Feet forrrcr. ALL that certain plot.pirtr nr parcel of food.with the buildinp and improvements thereon erected.ritwte. Ivinp and heinp in the SEE ATTACHED SHEETS (POUR DF.SCRIPTIOSS) TOGETHER with all tiAL title and intettrt. if any.of the two of the 6r+t part In and 10 atwy ndntent and. sada al.uldnit the above deaerihed Pratwlmrs to the"nder'lines t"hrtroft TOiG1i HER wills the a pwMwwtuwaora th OLD d all the fpremiere he�eittnpranFied nnlnhts of hkhr cap#}^f n:f fihathe ryret nd Part t part to o 1 m hrfrm nrd to�144 Px lrw me niff aaaaiptrw of On:pdAVE AN TO rty the wand part fnrevrr. Ati ff tt o i,aH of the Gast part t rxtnantw Li wt the pang a(the fiM pan has aol dot.or wlfertd anithing whereLl the maid pteNtrt f axe Irtwn arse rmb teed in wntC way w1 area ,waL u aforesaid. AYD dbrr patNr o11hr brat poli In e+mfr#ianeewtlh�iow 12 mf rimy .3zaw mow,ro,rnuata that e yar�rmf 'fir cwt part wl:ll aror)xo tlme corwa crab ax Erse shit rc royanrce weed w Alf bOodlr4Xo riF+e t andf4 iH the wam Brat to troll fond t0 fry ai'ed'6tH fear illi:pw+apKw�r ppwwY R If tbo pal rnatwt of tlra covet of tbmr Impnwrrrtasc xt lvelate uaitdR wny Patt oh11e dotal oI for aaast faa aary oOW n . Tlvr+.card:"pwrty""T1xaH Ire conatrurcel as if it lewd"patdita"`w'ire,xrx�tt^ rf tl;4a ladcratcrt to rrqo ek ea '. 1N WITNESS WHEREOF the parry of the fist p■rt ha•dal.ea.ctticd thfa.rk"ed the�arGy and year Ent above IsttritrswcE or: r� 1Mendelson "t Rcn fat i"w blase a ha Fox yy FIST:1000 ALL that certain plo1,piece or parcel of land,wish The buildings and improvements thereon erected.situate, SECT. 63 lying and being in the Toon of Southold. County of Suffolk and Stets of New Yorke DLR. 01 bounded and described as follows, LOT 15 BEGINNING st s point on the eastor7ynide of Nurtoa's Lane distant 263.48 feet. nouthcrly from tlae southerly and of the arc of a curve connecting the said cawterly nide of Barton's trine with the southerly side of Biddle 'Road and from said point of beglaning running thence i9artli 10 degrees 33 painutes 00 seconds Vest along the said essterty side of llo'rton's Lane a distance of 263.48 feed tunning thence on a curve to the; right baving a radius of 86.0 feet a distance of 116.57 feet to a point on the anutherly We of Middle Road; thence along the southerly side of Hid'dle Road. North 67 degrees 06 minutes 40 scconda East. a.distance of 263.16 feet to a point, running thence 800'tla 9 degrees 37 minutes 50 seconds East a distance of 333.91 fent to a point, and running tbence South 67 degrees 06 minutes 40 aeoncda'11ust a distance of 326.89 feet to the easterly' tide of Norton's Lane at the point or place of BECIh"NINC, BEING AND INTUDED TO BE the same premises conveyed to the party of the first part by deed dated December 31. 1996 and which-was recorded in the Office of the Suffolk County Clerk's on February"21. 1997 at Liber 11817 Pape 272. TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the nart of town officenq and emnlovees.The Durpose. of fhN forin is to nraiAtfle Information which can-.iIELLthe town of nnmi—hLo And 31191—V Litt(Ltike rwhatcvcr action is necessary to avoid same, YOUR NAME: RM-6 in the name of someone cht or afher entity,such as a (Last name,first name,middle initTAI-0111—itss you areapplying 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) ;r ') (j � / A/ Planning Do you personally(or through your c nipany,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? telationship"includes by blood,marriage,or business interest."Business interest" means a business,including a lum nership,in which the town officer or employee has even a partial ownership of(or employment by)a corpora *off i 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 spousei 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 isli corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not zic. J, proof601 Q an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this day of 20 /6P Signatur 1P Print Nainc 1-6 .a APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM The Town of Squthol(Ps Code,of Ethics proljibis conflicts of it'iterest on the part of town officers and employees,The psu of this form is to, provide inforination which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: NORTH FORK UNITED METHODIST CHURCH (Last name,first name,middle initial,unless you are applying in the of Wsomeone 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 VarianceTrustee Permit ................... Change of Zone�ITCoastal Erosion Approval of Plat Mooring Other(activity) Planning S Do you personally(or through your company,spouse,sibling, parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest"means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5% of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person _ Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee. Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) — A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) —B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) Q an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP ................................... ............................... Submitted 11 day of� I f I Signature Print Name NORTH FORK UNITED METHODIST CHURCH AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM 'r I,eTow r,of S q u t I i o I d's Code o r T t_tj tro11i1)its conflicts 0 f i I I t encou"Ail Me 011 of this form is icts of interest and allow it to take WhAtever action is necessary to avoid same. YOUR NAME: WILLIAM D. MOORE (Last name,flrsi'name,middle initial,unless..ss 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) A�) Planning JJ 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 X 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) Q an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP ........................................... ............................ ................. ......... da. of Submitted this. 01 2014 Signature ww .......... Print Name WILLIAM D. MOORE AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS TOWN OF SOUTHOLD WHEN TO USE THIS FORM: This form must be completed by the applicant for any special use permit, site plan approval,use variance,area variance or subdivision approval on property within an agricultural district OR within 500 feet of a farm operation located in an agricultural district. All applications requiring an agricultural data statement must be referred to the Suffolk County Department of Planning in accordance with Section 239m and 239n of the General Municipal Law. 1. Name of Applicant: METHODIST Applicant: ED .,,,,._m.. 2. Address of R 3. Name of Land Ownefother Othan BOAp286tot :J CLdTI- NY 1935 (. C/O Marilyn )E�.� �.. 4. Address of Land Owner. / w� ri y t ,Wit.X38 �i , s Highway, Hauppau e, NY 11788. ...,m—.. 5. Description of Proposed Project:_ CCSI�STR'�TIOTV��iUUSE_OEWOR'SH.IP—.. .. S �,I�HOL, ..�m. ... 6. ocat on of(roper y (road and Tax map number) 61-1-15 15 ... . .43960 CR �. . 7. Is the parcel within 500 feet of a farm operation? {I Yes { }No 8. Is this parcel actively farmed? {X 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, I. Peconic Land Trust PO Box 1776 Southampton NY 11969 2. 3. 4. 5. 6. (Please use the 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. 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# 61-1-15 -43960 CR - SOUTHOLD The Application has been submitted to(check appropriate response): Town Board 0 Planning Dept. © Building Dept. 0 Board of Trustees 0 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital 0 construction,planning activity, agency regulation, land transaction) (b) Financial assistance(e.g. grant,loan,subsidy) (c) Permit, approval, license,certification: Nature and extent of action: vvvv_. CONSTRUCTION OF _HOSE OF WORSHIPU E Location of action:43960 CR 48, and Horton's Lane Southold Site acreage: 2.437 _........ Present land use: vacant land _. . Present zoning classification: LB _. ....� ....._._.. 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:.„NORTH FORK UNITED METHODIST�wwwwwwwwwww._. (b) Mailing address: PO BOX 1286 CUTCHOGUE NY 11935 (c) Telephone number: Area Code( )L631) 905-6743 (d) Application number,if any:. ___ ...._ ..............._ Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No 0 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. WYes 1:1No � Not Applicable I Ise is perrnitted by special eXreption. will 1 ise existing pi jh1iC i iteletetnS a-nri mad infrasta icti ire and is located awav from residential uses ................ 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 [:r]- No Not Applicable No impact on these resources Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ® Yes r" No E Not Applicable Proposed construction covers less that 10 percent of property (or one half of the permitted coverage]and will contribute to Rest e KrF t t of this ortwon of-lm oute 48 in S -thr oomp eTn nTinq 'ie surr unUink properf ii ._ Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria Yes 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 9 Yes 0 No 0 Nott Applicable _ in t . .quer _ b. � ned in ao�orc&ance with� Healt at qusernentst Proposed will a has no other imp t on water sualiit o supply. wr e os quality r su I . Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. Yes [] No Not Applicable ................ .......... Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section HI — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes D No 0 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. Ed YesEl No D Not Applicable ..Allj.n-comp,Uatic",th-appJicableJaws-and-reg,ulations—....-..--...--...-............................. ................. ....... ----—-- ....... 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. E] YeED NoD Not 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 through 56 for evaluation criteria. E Yes F-1 No 0 Not Applicable A ttach additional ....... .. .... .... .._........� sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No❑ Not Applicable .... ��.._._.�_— ._..........._. —.. ._._._...... _...mm... .............. Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III— Policies; Pages 62 through 65 for evaluation criteria. ® Yes ❑ No❑ Not Applicable p '_ of interfere withuc ricultural Construction and use will be ,_laced away from ad'oinirr agricultural I'as�ds; will IT n operations _. ... ... ................ _ .......� Attach�additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. 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