HomeMy WebLinkAbout1000-122.-3-26 OFFICE LOCATION: ��OF SO(/jy� �ILING ADDRESS:
Town Hall Annex , �O l� P.O. Box 1179
54375 State Route 25 � � Southold, NY 11971
(cor. Main Rd. &Youngs�1ve.) N �c
Southold, NY 11971 � � �pQ Telephone: 631 765-1938
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LOCAL WATERFRONT REVITALIZA�'ION PROGR.AM
TOWN OF SOUTHOLD �
� MEMORANDUM �
To: Leslie Weisman, Chair
Members of the Zoning Board of Appeals
From: Mark Terry, Principal Planner ��
, � LWRP Coordinator �
Date November 19, 2015
Re: Coastal Consistency Review for ZBA File Ref. HEATHER and RICHARD PETROWSKI #6896
SCTM# 1000-122-3-26
HEATHER and RICHARD PETROWSKI #6896- Request for Variances from Article XXII Section 280- �
116B and Article XXIII Section 280-1�4 and the Building Inspector's October 26, 2015 Notice of
Disapproval based on an application for building permit for demolition of existing building and �
construction of a new single family dwelling, at: 1) less fhan the code required bulkhead setback of 75
feet, 2) less than the code required front yard setback of 35 feet, located at; 295 East Legion Avenue �
(adj. to James Creek) Mattituck, NY. SCTM#1000-122-3-26
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 informatior� provided on the LWRP Consistency Assessment Form submitted to this
department, as well as the records available to me, it is my recommendation that the actions are
CONSISTENT with the Policy Standards and therefore are CONSISTENT with the LWRP based on the
� following: �
1. Due to the size of the parcel there is no ability to relocate structures outside of the 0.2
, Percent Annual Chance Flood Hazard Areas. The base flood elevation is 6'. The proposed
first floor-elevation is 8.2'. The new design mitigates threat of property damage from storm
events and furthers the LWRP policies.
2. In the event that the action is approved, the establishment of a landscaped or non-turf,
vegetated buffer comprised of native plant species should be required landward from the
bulkhead to further Policy 6. It is recommended that the buffer be the length of the bulkhead
and 15' in width.
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 • •
Off'ice Location: � �o���F $Q(��.y�l Mailin�Address:
Town Annex/First Floor,Capital One Bank � 53095 Main Road
54375 Main Road(at Youngs Avenue) � � P.O. Box 1179
Southold,NY 11971 � • Q Southold,NY 11971-0959
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� http://southoldtown.northfork.net
BOARI) OF APPEALS
TOWN OF �OUTHOLD �
Tel. (631) 765-1809 Fax (631) 765-9064 D � v � � � �
October 27, 2015 Q C T � '� 2015
Southold'Fawn
Planning Board
Mark Terry,Principal Planner
LWRP Coordinator
Planning Board Office
Town of Southold
Town Hall Annex �
Southold,NY 119'11
Re: ZBA File Ref. No. # 6896 PETROWSKI, Richard
Dear Mark:
We have received an application for demolition of an existing building and construct new
single family dwelling. A copy of the Building Inspector's Notice of Disapproval under
Chapter 280 (Zoning Code), and survey map, project description form, are attached for
your xeference.
Your written evaluation with recommendations for this proposal, as required under the
, Code procedures of LWRP Section 268-SD is requested within 30 days of receipt of this
letter.
Thank you.
Very truly yours,
Leslie K. Weisman
Chairperso
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� FORM NO. 3
' TOWN OF SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD,N.Y.
1\TOTICE OF DISAPPROVAL `
DATE: October 26, 2015
TO: Nancy Duryer(Petrowski)
PO Box 632
Southold,NY 11971
Please take notice that your application dated June}10, 2015:
For permit to demolish an existing buildin�;and coristruct a new single-familv dwellin�
at:
Location of properly: 295 East Legion Avenue, Mattituck,NY
County Tax Map No. 1000 - Section 122 Block 3 Lot 26
Is returned herewith and disapproved on the following grounds:
The,�roposed construction on this non-conformin�12,526 sq. ft.parcel in the R-40
District is not permitted pursuant to Article XXIII Section 280-116B which states;
� "All buildings located on lots upon which a bulkhead, concrete wall,riprap or similar
structure exists and which are adiacent to tidal water bodies other than sounds shall be set
back not less than seventy-five(75)feet from the bulkhead." .
The new dwellin�will have a setback of 46:8f feet to the existin�bulkhead.
In addition the�proposed construction is not permitted pursuant to Article XXIII Section
280-124• which states non-conformin�lots measurin�less than 20,000 sQuare feet in
total size require a minimum front setback of 35 feet.
The survev shows a front yard setback of 20.6 feet.
CC: file, Z.B.A.
Note to Applicant: Any change or deviation to the above referenced application may.
require additional review from the Southold Town Building Department.
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Fee:$ Filed By: Assignment No.
APPLICATION TO THE SOUTHOLD TO�VN BOARD OF APPEALS
AREA VA,RIANCE . �
House No. 295 Street E. Legion Avenue Hamlet Matfituck �
SCTM 1000 Section �� Block 3 Lot(s) 26 Lot Size 12,526 7,flIIe R-40
,
I(WE)AppEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR �
DATED October 26,2015 BASED ON SURVEY/SIT�PLAN DATED 2-9-2015
Applicant(s)/Owner(s): Heather�Richard Petrowski
� 2795 Ole Jule Lane Matfituck, NY 11952
Mailing Address•
Telephone• Faz- Email-
NOTE:In addition to the above,please complete below if applicatiom is signed by applicanPs attorney,agent,
arclutec�builder,contract vendee,etc.and name of person who agent represents:
Name of Representative: Nancy Dwver Desiqn Consulting for(x1 Owner( )Other: '
Address: PO Box 632 Southold, NY 11971
Telephone: 631-765-8905 Faz: Email: nanc�+dwverdesignla�aoi.com
, �
Please check to specify who you wish cornespondence to be mailed W,,�»m tfie a6ove naines: . �
( )Applicant/Owner(s), (�Anthorized Representative, ( )Other Name/Address below:
WHEREBY TBE BUII.DING'INSPECTOR REVIEWED SURVEY/SITE PLAN
DATED 2-9-2015 and DENNI�D AN APPLICATION DATED June 10,2015 FOR ,
(�Bailding Permit '
' ( )Certificate of Occupancy ( )Pre-C¢rtificate of Occupancy
( )Change of Use
( )Permit for As-Built Construetion
( )Other:
Provision of the Zoning Ordinance Appealed. (Indicate Artica�section,Subsection otZonmg
Ordinance by nnmbers.Do not quote the code.)
Article:XXiII Section:280-116B 8�280-124 Subsection:
Type of Appeal. An Appeal is made for: �
, (�A Variance to the Zoning Code or Zoning Map.
( )A Variance due to lack of access reqn�ed by New York Town Law-Section 280.A.
( )Interpretation of the Town Code,Article Section
, ( )Reversal or Other •
A prior appeal( )has, (�has not been made at anv time with YeSDect to thiS DYODertV.
UNDER Appeal No(s). Year(s). .(P�ease be sure to
research before completinglhis question or call our o,�ice for assistance) , ` -
� Name of Owner. . ZBA File#
)
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REASONS FOR APPEAL (Please be spec�,additional sheets may be used with preparer's
- signature nvtarized): '
1.An undesirable change will not be produced in the CHARACTER of the neighbor or a detriment to nearby ,
properties if granted,because: �
The proposed new residence is consistent with the sur�unding dwellings and their setbacks,therefore
it wifl not change the character of the neighborhood.
�
2.The benefit sought tsy the applicant CANNOT be aclrieved by some method feasible for the applicant to
pursue,other than an area variance,becavse: ` , �
� . � The size of the lot,the irregular shape,and the existing bulkhead are all factors in dictating the location
of where a dwelling can be located on the property.
3.The amount of relief requested is not substantial because:
The proposed construction area needing relief is not svbstantial because it is only 4.3%of the total lot:
4.The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the
� neighborhood or districtbecause:
The variance is for a new single family dwelling in a residential neighborhood and construction
means and methods will ail be perFormed according to state�local codes and requirements.
� 5.Has the alleged difficulty been self created? {�Yes,or{}No Why:
Yes,in that the property owners are hopefui to build a new home on a non-confoRning lot.
Are there any Covenants or Restrictions concerning this land? {�No {}Yes(please furnish a copy) '
This is the 11rIIl�1IMUM that is necessary and adequate,and at the same time preserve and protect the
character of the neighborhood and the health,safety an(elfare of the community. �
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, Signature of li or Auth rized Agent
, (Age,nt mast sub AWhori�ation&om Ownec)
. �
Swom to before me this day
of ,20
Notary PubGc
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` APPLICANT'S PROJECT DESCRIPTION
APPLICANT: Dwyer for Petrowski DATE PREPARED: 10-10-2015
1.For Demotition of E�sting Building Areas
Please describe azeas being removed: An existing,run down, 18 X 20 garage will be removed from the site
� , II.New Construction Areas(New DweD'mg or New Additions/Extensions): .
Dimensions of first floor extension: �Re9ular, 1480 sq.ft. `
Dimensions of new second floor: irregular, 1480 sq.ft. '
Dimensions of floor above second level: Attic within roof line
Height(from finished ground to top of ridge): 30'-8" +/-
Is basement or Iowest floor azea being constrixcted?If yes,please pmvide height(above ground)measured from
natural existing grade to first floor: 3'-6" +/- �
,
III.1'roposed Construction Description(Alterations or Structural Changes)
(Attach extra sheet if necessary).Please describe building azeas: `
Number of Floors and General Characteristics BEFORE Alterations: Existing 1 story garage
Construction indudes removal of existing structure,and a new 2 ory we ing
Number of Floors aud Changes WITA Alterations: oors
� ,
� N.Calcnlations of building areas and lot coverage(froffi surveyor):
Existing square footage of buildings on youi property: 370 sq.ft.
Proposed increase of building coverage: g°�
Square footage of your lot: 12,526 sq.ft.
Percentage of coverage of your lot by building area: 11.8%
V.Purpose of New ConsLruction• Is to provide a new single family residence �
VI.Please describe the land contours(flat,slope%,heavily wooded,marsh area,etc.)on your land and
how it relates to the difficnity in meeting_the code requi�ement(s): -
Land is partiaily wooded,and grasivally slopes down from the road towards the existing bulkhead.
� Please submat 8 sets of photos,labeled to:show different angles of yard areas after stal�ng corners for
new construction,and photos of bailding area to be altesed with yard view.
4/2012 -
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Q{JL`S11O1\L\t�liW
FOR FILING WITH YOUR ZBA APPLICATION �
�
A. Is the subject premises listed onthe real estate market for sale?
� X Yes No
B. Are there any proposals to change or alter land contours?
X No Yes please explain on a�ttached shee�
C. 1.)Are there azeas that contain sand or wetland grasses? �ot on this property,but neighboring
2.)Are those areas shown on the survey submitted with this application? Yes
3.)Is the property bulk headed between the wetlands azea and the upland building
' az�� Yes
4.)If your property contains wetlands or pond areas,havey ouu contacted the Office of -
the Town t�vstees for its determination of jurisdiction? Y� Please confirm status
of your inquiry or application with the Trustees: �A required first
- and if issued,please attach copies of permit with conditions and approved survey.
D. Is there a depression or sloping elevation near the azea of proposed construction at or
below five feet above mean sea level? Yes,at 5 feet '
E. Are there any patios,concrete barriers,buikheads or fences that e�cist that are not
shown on the survey that you are submitking? NO Please show area of the
• structures on a diagram if any exist or state none on the above line.
F. Do you have any constr�iction taking place at this time concerning your premises7 � No �
' yes,please submit a copy of your building permit and survey as approved by the Building .
Deparhnent and please describe:
G. Please attach all pre-certificates of occupancy and certificates of occupancy for the subject
premises. If any aze lacking,please apply to the Building Department to either obtain them
or to obtain an Amended Notice of Disapproval.
H. Do you or any co-owner also own other land adjoining or close to this parcel? Y�
� If yes,please label the proximity of your lands on your survey. Property directly to the west is owned
by a trust,in which Richard Petrowski has partial ownership of.
I. Please list present use or opezations conducted at this parcel . �nd with garage, used
for storage and dock •and the proposed use single family residence with
' �a�a,ge and exisfing dock .(ex:existing single family,proposed:same with
garage,pool or other)
/�•a�•/.� �
Authorized s e and D t
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AGRICULTURAL DATA STATEMENT
ZONING BOARD OF APPEALS , �
, TOWN OF SOUTHOLD
WHEN TO USE TffiS FORM: This form must be completed by the irppl�ca►it for a�ry special use permi�
site p[an appmva�use varianc�area variance or subdivRsion opproval on properly within an agricultural
disdict OR within SOO,feet of a farm operation located in an agricultural district All appli'cations
requiring an agricultural data statement raust be referred to the Su,f j`'olk County Deparhnerit of Planning
in accordance with Section 239m and 239n of the General Mu�icipal Law. . .
'1. Name of Applican� Dv►ryer far Petrowski
2. Address of Applican� PO Box 632 Southold, NY 11971
3. Name of Land Owner{if other than�plicant): Petrowski
4. Address of Land Owner. 2�95 O Jule La e, ,
5. Description ofProposed Proposed new single family dwelling
Project:
6. Location of Properly:(road and Tax map
number) 295 E.Legion Ave, Mattituck 1000-122-3-26
� 7. Is the parcel within 500 feet of a farm operation? {}Yes {�No
8. Is tlus 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 nunnbers will be provided to you by the Zoning Boazd Sta�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 '
�1.
�
2. ` .
3.
4.
5.
6.
(Please use the back of this page if there are additional property owners)
, �� / � � / � S
Signature of App cant Date
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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 ttus statement
2.Comments returned to the local Board will be taken into consideration as part as the overall review of this application.
3.Capies of We wmpleted Agriault�ual Data Statement shall be sent by applicant tio the property owners identifial
above. The cost for mailing shall be paid by the Applicant at�e time the application is snbmitted for review
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` _ ' 617.20 �
Appendax B `
Short Environinental Assessment Form
Instructions for Comuleting
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 fimding,are subject to public review,and may be subject to further verification.
Complete Part 1 based on information currently available. If additional research or inve�tigation wonld be needed to fully
respond to any item,please answer as thoroughly as possible based on current informatian. �
�
Complete all items in Part 1. You may also provide any additional information wlrich you believe will be needed by or useful
to the lead agency;attach additional pages as necessary to suQplement any item.
Part 1-Project and Sponsor L�formaflon i
Name of Acfion or Project: � ,
Proposed Petrowski Residenoe
Project Location(descnl�e,and attach a location map): �
295 E_Legion Avenue, Mattituck
Brief Description of Proposed Acfion: �
Project involves removal of an e�usting 1 story garage on a parcel of land and construction of a new
� 2 story,single family dwelling.
Name of Applicant or Sponsor. Telephone: 63'i 765-8905
Nancy Dwyer Design Consulting, Inc_ E M� nancyduryerdesign@aol.com
Address:
� PO Box 632 _
City/PO: Southold State: NY Zipth'��:
1.Does the proposed action onty involve the legislative adop6on of a plan,loc�l law,ordinance,� NO YES
administraiive mle,or regulation? -
If Yes,attach a narrative description of the intent of the proposed action and the environmental resources tUat X
may be affected in the municipality and proceed to Part 2. If no,continue to ques6on 2.
2. Does the proposed action require a permit,approval,or funding&om any other govemmental Agency? NO YES
If Yes,list ageniy(s)name and permit or approval:
, Southold Town Tn�stees,Building Departrnent, NYS DEC,SufFolk Courrty Health Dept. X
3.a Total acreage of the site of the proposed action? .40 acres or 12,526 sq.ft.
b.Total acreage to be physically disturbed? 1600 sa.ft. acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the appiicant or project sponsor? .40 acres -
4. Check all land uses that occur on,adjoining and near the praposed action. ,
❑Urban ❑Rural(no�agriculture) ❑Indnstrial ❑Commercial �[Residential(saburban)
❑Forest ❑Agriculture qCAquatic ❑Other(specify): ,
❑Parkland ;
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5. Is the proposed acfion, '. � � NO 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 nahual NO YES
]andscape? ' ; X
7. Is the site of the propased action located in,or does if adjoin,a state listed Critical Environmental Area? NO YES
If Yes,identify:
' X
8. a Will the proposed action result in a substantial mcirease in tra�c aboee present levels? NO YES
t
� X
b.Are public transportation service(s)available at oi near the site of the proposed action? X
4 •
c.Are any pedesfrian accommodations or bicycle roirtes 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 exc�ed requirements,descnbe design feawres and technologies: �
�
X
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,descnbe method for providing potable water. New wate�supplv to be connected to x .
existing public water located in road
11.Will the propased action connect to existing wastewater utilities? NO YES
� If No,describe method for providing wastewater treatmen� Proposed new septic system as X
�RRGed for with Suffolk Go�ntrHealth De�t
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"m 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 e�sting wetland or waterbod�
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: X
14. Identify the typical habitat types that occur on,or ate likely to be found on the project site. Check ail that apply:
❑Shoreline ❑Forest ` ❑AgriculturaUgrasslands ❑Early mid successional
- C�Wetland ❑Urban ' ❑S�burt�an "��
- 15.Does the site of the proposed action contain any speeies of animal,or associated habitats,listed NO YES
� by the State or Federal govemment as threatened orsendangered? X
16.Ts the project site located in the 100 year flood plain? NO YES
' X
17.WiII 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 C]YES X
b.Will sto�water discbarges be directed to established conveyance systems(nmoff and storm drains)?
If Yes,briefly descnbe: , � ❑NO�YES
, Project will comply with the Town s stormwater management ptan and h ve dryweils
J to contain all runoff � }
,Page 2 of 4
. . � + �
18.Does the proposed actian include construction or other activiries that result in the impoundment of NO YES
water or o�er liquids(e.g_retention pond,waste lagoon,dam)?
If Yes,explain pmpose 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'1
If Yes,descn'be: ' � ' X
. ,
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: } X
I AFFIRM TA.AT THE INFORMATION PROVIDED ABOVE IS TRIIE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE -
APPlicant/sponsor �Yer for etrowski ; � Date: !�'o? �o•/�
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 1 and other materials submitted by the project sponsor or
otherwise available to the reviewer. �VVhen answering the questions the reviewer should be guided by the concept`�iave my
� responses been reasonable considering the scale and conte�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 pmposed action result in a change in the use or intensity of use of land?
3. Will the proposed action impair the characber or q�aliry of the existing communit}�l
4. Will the proposed action have an impact on the environmental characteristics that caused the
establishment of a Critical Environmental Area(CEA}?
5. WiII,the proposed action res�ilt in an adverse change in the existing level of traffic or .
i
affect existing infrasiructure 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 elcisting: _
� a.public/privatewater supplies? .
b_public/private waste�vater treatment ut�7ifies? ,
� 8. Will the proposed ac6on impair the chazacter or quaiity of important historic,azchaeological,
azclutectural 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
. • i �
- . ' , No,or Moderate
small to large
� impact impact
� may may
. occar occur
10. Will�the proposed action result in an increase in the potential for erosion,flooding or drainage
problemsY , s
r
11. Will the proposed acfion create a hazazd to environmental resources or human health?
Part 3-Determination of significance. The Lead Agency is respons�ble for the completion of Part 3. For every
question in Part 2 that was answered"moderate to large impact may occuc",or if there is a nesd to explain why a particuiar
element of the proposed action may or will not result in,a significant adverse environmental impac�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 ihe lead agency determined that the impact
may or will not be signif cant Each potential impact should be assessed considering its setting,probability of occuaing,
duration,irreversibility,geographic scope and magnitude. Also consider the potential for short term,long-term and
cumulative impacts. , E
,
❑ Check this box if yon have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action may result in one or more potentially iarge or significant adverse�pacts and an -
, enviconmental impact statement is required. -
❑ Check this box if you have determined,based on the information and analysis above,and any sapporting docamentation,
that the pmposed action will not result in any sigiificant adverse environmental impacts.
� _
Name of Lead Agency Date
Print or Type Name of Responsi'ble Officer in Lead Agency Tide of Responsible Officer
' SignaUue of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer)
'
�
, Page 4 of 4
, k
Board of Zonin�AoneaLs Auplication `
. AUTHORIZATION �
(Where the Applicant is not the Owner) �
�
I, ��c�Q�� I'e�"�o�,,s�; ; residing at �''Jg� Dl,� JV(,L ��2..
(Print properiy owner's name� ; (Mailing Address) ,
���'``��1.�G� , do hereby authorize ��.�Gvi �w y�d o�
� , (Agent)
I�.rr�(�w1 �1�/(/Y t/�-s��-' � to apply for variance(s)on my behalf from the
Southold Zoning Board of Appeals. �
/ ��-��T • .
(Owner's Signature) ,
/� 'c�e�� �"Irows�',� �
(Print Owner's Name) : '
` f
i
. : � ; • � ; .
� y ,
�. ' ' �
Al'PLICANT/OWNER � �.
- TRANSACTIONAL DISCLOSURE F08M ' "
The Town of Southold's Code of Et6fcs uro6�bits eonthcts of interest on the nart of Mwn o�cers snd emplovees.The anroose
of this form is to nrovide information which can�lert the town of oossibte eondids of intere�and alfow it to t9ke wl�tever
� action is neoesssr9 to avuid sem� : �
YovRrra�: �r ow�lc.�.'� Y2�GG�.���-� `� - �
� • (L�stnnm�first name,mtddte tnitial,mless yoa are upplyiog�the name of someone else or othe entity,�ch as a
� eomQagy.If sq 3IId'i�te fhe ot6ei peiSOII'�S or compauy's nsme.) �
TYPE OF APPLICATION:(Check all that apply�
Taa grievance - Bmld'mg Permit
Vari�nce � � - - Trastee Perput -
Chaage of Zone - ,� • Co�l Erosion
Approval of Plat - x Mooring
Other(activity) Plannfmg
Do yoa personally(or tl�roagh yonr companp,spons�,sbling,psrent,or ch1�have a retationchip with any off cer
or employee of the Town of So�hold?"Relattonslu�'includes by blood,marrisg�or bnsin�ioterest"Busfaess
interest"means a bnsmas,inclading a partnership,in wLich the town o�cer or employee h�is even a partial
ownership of(or employme�by)a corporation<in-which the town officer or emptoy�owns more than S%of the
� shares. ' ,
YES NO
If yon answered�YES",complebe the balance of this form and date aad sign where indfcated.�
Name of person emplo�ed by the Town of Soadiold
Title or pos�tion of t6at person �
Describe tLe relationship between yourseif(the appticant/agent/represe�stive)and the,town officer or employee.
Either check the appropriate line A)throngh D)snd/or descn'be in the space provided.'
The town o�oer or employce or his or her sPouse,siblinp�Par��or c6�d is(c6eck�ll that aPPh�)=
A)the owner of gr�ater i6at 5%of the ahares of the corpor�te sboch of the applicant(wben the applic�nt is a
coY'Puration) - , �
�
B)the legal or beneficial owr�er of aoy interestin a non�orporate entity(wheu tLe applicaat is not a corporatlon)
C�an oH'ieer,director,Patt�er,ur emPloYee of tii�apphe.aa�or - �
D)the adv�l apptieaat
- DESCRIP�`ION OF RELATIONSHIP . t •
� i
Sabmitted this dsy of ,24 � '
Signatn�w— � (
P,rint Name ,�i e� o�� I'-e� � . -
row.f��` ' t
.
' y �
� AGENT/REPRESENTATIVE
� TRANSACTIONAL DISCLOSURE FORM �
The Town of�Southold's Code of Ethics prohibits conflicts of interest on the aart of town o�cers and emolovees.The ouroose
of this form is to nrovide information which can alert the town of�ossible contlicts of interest and aIlow it to take whatever
ac�ton is necessarv to avoid same. , ,
YOUR NAME-
Dwyer,Nancy,i4. '
•(Last name,first name,middle initisl,anless yon ure applying in the name of someone elsc or other entity,snch as a
company.If so,indicate the other person's or compaay's name.)
TYPE OF APPLICATION:(Check all that apply)`
Taz grievance , Bailding Permit
Variance X Trustee Permit
Change of Zone Coastal Erosion
Approval of Plat Mooring
Other(activity) Planning �
r
Do you personally(or through yonr company,spouse,sibling,parent,or child)have a relationship with any officer
or employee of the Town of Sonthold?KRelationship"inclndes by blood,marriage,or bnsiness interest.`Business
interest"means a bnsiness,inclnding a partnership,in which the town.officer or employee has even a parlial
ownersWp of(or employment by)a corporation ink which the town ofRcer or employee owns more than 5%of the
shares. �
YES NO x �
If yon answered"YES",complete the balance of tWs form and date and sign wLere indicated.
� Name of person employed by the Town of So�hold
Title or position of that person i
�
. Describe the relationslup 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. '
i �
�
The town oflicer or employee or his or her spouse,sibfing,parent,or ch�7d is(cLeck all thet 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)
G�an of�icer,director,partner,or employee of tlie applicant;or '
� D)the actual applicant ,
, ,
DESCRII'TION OF RELATIONSHIP � `
� �
. �
Snbmitted this o��p da of 20� , ,
�
;
Signature ;
Print Name � (�21 �
� , .
, . . , �
To�ofsontboia �
LWRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS i - ,
1. All applicants for pernlits�` including Town of Southold agencies, shall complete this CCAF for
proposed actions that are subject to the Town of,SouthoId Water&ont Consistency Review Law. This
assessment is intended to supplement other information used by a Town of Southold agency in
, making a determination of consistency. *F�ccept minor exempt action.s including Building Permits
and other ministerial permits not located within the Coastal Erosion Hazard Area.
2. Before answering the questions in Section C, the prepazer of this form should review the exempt
minor action list, policies and explanations of each policy contained in:the Town of Southold Loca1
Water&ont Revitalization Program. A proposed action will be evaluated as to its significant
beneficial and adverse effects upon the coastal azea(which includes all of Southold Town). -
; �
- 3. If any question in Section C on this foma is answered "yes",then the proposed action may affect the
achievemeirt 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 t1�at it is consistent to the maximum extent practicable with the LWRP policy
standards and conditions. If an action cannot be certified as consiste� with the LWRP policy
standards and conditions,it shall not be undertaken. � , '
A copy of the LWItP 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 1�'braries and the Town Clerk's office.
B. DESCRIPTION OF SITE AND PROPOSED ACTION
. �
; �
122 3 26 �
SCTM# - - {
�
The Application has been submitted to(check appropria.te response):
Town Board � Planning Dep� � Build'mg Dept � Board of Trnstees 0
�
1 _
1. Category of Town of Southold agency action(check appropriate response): � '
�
(a) Action undertaken directly by Townjagency(e.g.capital 0
construction,planning activity,agen�Y regulation,land transaction) �
(b) Financial assistaace(e.g.grant,�loan,�subsidy)
(c) Permit,approval,license,certifica.tion: �
-. �
Nature and extent of action: ;
Removal of an existing gara�ge on property and proposed construction of a
new single family dwelling. �
� ,
. , . �
Location of action� 295 E.Legion Ave. Mattituck
�
. ,
Site acreage: .40 acre i
Present land use: Vacant land with small gara9e and dock
Present zoning classification: R-4o ; ,
2. If an application for the proposed action ha`'s been filed.with the Town of Southold agency, the following
information shall be provided: � '
(a) Name of applicant: • Petrowski
2795 Ole Jule Road Mattituck NY 11952
� ,
(b) Mailing address: '
i �
(c) Telephone number:Area Code( ) 516-857-8751
(d) Application number,if any:
Will the action be directly undertaken,require fimding,or approval by a state or federal agency?
Yes � No❑ If yes,which sta.te or+federal agency? Trustees, Building
�
DEVELOPED COAST POLICY ;
S
Policy 1. Foster a pattern of development in the Town of Southold that enhaaces community character,
• preserves open space,makes efficient use of infrastructure,makes beneficial use of a coastal location,and
minimizes adverse effects of development. See LWRP Section III—Policies;Page 2 for evaluation
criteria. # �
�Yes � No � Not Applicable . `
� a �
project is proposing a dweliing consistent with the surrounding neighorhood
)
Attach additional sheets if necessary ; , '
Policy 2. Protect and preserve historic and �rchaeological resources of the Town of Southold. See
LWRP Section III—Policies Pages 3 through 6 for evaluation criteria
� Yes 0 No 0 Not Applicable �
� �
,
, _ -
�
, �
. . � �
Attach additional sheets if necessary � �
Policy 3. Enhance visual qnality and protect i scenic resources throughout the Town of Southold. See
LWRP Section III—Policies Pages 6 through 7 for evaluation criteria
� Q Yes Q No � Not Applicable �
ti
i
� J �
t
t
a
i `
Attach additional sheets ifnecessary ' , '
NATURAL COAST POLICIES �
;
, �
�
,
� Policy 4. -Minimize loss of life, structures, andt natural resources from flooding and erosion. See LWRP
Section III—Policies Pages 8 through 16 for evaluation criteria
;
� Yes � No � Not Applicable E
,;
� J
1 �
{
3
i
Attach additional sheets if necessary �
t .
f
Policy 5. Protect and improve water quality atid supply in the Town of Southold. See LWRP Secfion III
—Policies Pages 16 through 21 for evaluation criteria
�' Yes,0 No �Not Applicable �
F
Attach additional sheets if necessary .
� Policy 6. Protect and restore the quality and function of the Town of Soutb.old ecosystems including -
Significant Coastal�sh and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22
through 32 for evaluation criteria. ; �
� Yes �No� Not Applicable - ;
Silt fencing and runoff containment will all be implemented prior to and during construction in an effort to protect
the surrounding waters and properties. �
i .
. , � ,
, �
, ,
Attach additional sheets if necessary �
Policy 7. Protect and improve sir quality in jthe Town of Southold. See LWRP Section III —Policies
Pages 32 through 34 for evaluation criteria. ;
�r Yes � No� Not Applicable �
s
i
�
�
� 1 .
Attach additional sheets if neces'sary _
t
Policy 8. Minimize environmental degradation in Town o� Southold from solid wwaste and hazardous
substance.s and wastes. See LWRP Section III=-Policies;Pages 34 through 38 for evaluation criteria.
i
� Yes ❑ No � Not Applicable ; <
_ �
,
PUBLIC COAST POLICIES �
, � ' �
Policy 9. Provide for public access to, and recxeational use of, coastal waters, public lands, and public
resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for eaalnation
criteria. '•,
- 0 Ye�J No� Not Applicable �
�
�
Attach additional sheets if necessary
WORI�ING COAST POLICIES {
i . �
Policy 10. Protect Southold's water-dependent#uses and promote siting of new water-dependent uses in
suitable locations. See�.WRP Section III—Policies; Pages 47 through 56 for evaluation criteria.
0 Yes ❑ No � Not Applicable �
. • ; . �
. • ,
� `
Attach additional sheets if necessary � �
Policy 11. Promote sostainable use of living marine resowrces i� Long IsIand Sound, the •Peconic
Estuary and Town waters. See LWRP Section III—Policies;Pages 57 through 62 for evaluation criteria.
0 Yes ❑ No � Not Applicable ' '
,
{
. s
' ,
;
Attach additional sheets if necessary
Policy 12. Protect agricultural laads in the Town of Southold. See LWRP Section III —Policies; Pages
62 through 65 for evaluafion criteria. -
�Yes ❑ No� Not Applicable ; ,
F �
�
�
1
1 �
Attach additional sheets if necessary
Policy 13. Promote appropria.te use and development of energy and mineral resources. See LWRP
5ection III—Policies; Pages 65 through 68 for-evaluation criteria.
�Yes ❑ No
0 Not Applicable
3
S
3
Created on 5/25/0511:20 AM � ,
I .
r
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TOWI� OF SOUTHOLD i
OFFIC� OF BUILDIATG INSPECTnR
TOtiVl`T IiALL :
� SOUTIiOLD, I�*E��' YOT'�K
CERTIFICAT� OF OCCUP��NCY
NO1VCOi�I`OR1YI1�'G•PRE111ISE5 �
THIS IS TO CERTIFY that the ' �
�/ Land � , Pre C.O. #- ZL4518
/ / Building(s) Date- June 17, 1986
/_/ Use(s)
located at 295 EAST LEGION AVE. - MATTITUCR .
Street Hamlet
shown on County tax map as Distrfet 1000, Section 122 . Block 3
, Lot 26 , doesinot�conform to the present Tuilding Zone Code of the ,
�Town of Southold for the following reasons:
Insufficient total area.
i
. I
On the basis of iaformation presented to the Buildi.ng Inspector's Office,
it has been determined that the above npnconforming /X7(Land %/Building(s)
/ /Use(s) existed on the effectice date the present Building Zone Code of the
Town of Southoid, and may be continued pursuant ta and subject to the appli-
- cable provisions of said Code.
� •
IT LS FURTHER. CER.TIFIED that, based upon information presen#ed to
the Buildi.ng Inspector's Office, the oscupancy and use for cvhich this Certifi- ;
cate is issued is as follo�vs: Property contains a wood framed, non residential
building, with three pitcher pumps; and a wood bulkhead on the water side �
o�nroTerty All this situated i.n the "A" Residential Agricultural zone
with access to East Legi�n Ave.
The Certificate is issued to__ MF„�,rn, RAVT*AR�
(01V112I'� 2CRA21x71�X7C1["tf�}
, o�the aforesaid building. �
Suffolk County Department of Health Approval NJA
Ul�'DER.WRITERS CERTIFICATE NO. N/A
NOTIC� IS HEftEBY GItTEN that fhe owner of the above premises Ii9S
NOT COI�SEI�ITED TO AN I1�SPECTI01� of the premises by the Building Inspec-
tor to determine if the premises comply�oi.th all applicable codes and ordin- °
ances, other than the Building Zone Code, and therefore, no such inspection
has been conducted. Ti�is Certificate, therefore, does not, and is not illtended
to certify that ttie premises comply with all other applicable codes and regula-
tions. .
��� � - '
Bui:di�� :n pector �
�
` / //�\` /
t � �� _��.%� / .�� �/•'� �/�\ � ��/ � �.'.� ,`���
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