HomeMy WebLinkAbout1000-113.-6-13 OFFICE LOCATION: O��oF SOUTyO� MAILING ADDRESS:
Town Hall Annex � � P.O. Box 1179
54375 State Route 25 � � Southold, NY 11971
(cor. Main Rd. &Youngs Ave.) � �
Southold, NY 11971 � � �Q Telephone: 631 765-1938
���COU�m,��'
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
MEMORANDUM
To: Leslie Weisman, Chair
Member$ of the�Zoning Board of Appeals
From: Mark Ter Princi al Planner �
rY, P ,
LWRP Coordinator
Date: August 19, 2015
Re: Coastal Consistency Review for ZBA File Ref SUSAN CACCHIOLI #6881
SCTM#1000-113-6-13
SUSAN CACCHIOLI #6881 - Request for Variances from Article XXIII Section 280-124 and the Building
Inspector's June 12, 2015 Notice of Disapproval based on an application for building permit for second
story addition/alterations to existing single family dwelling and legalize `as built' deck addition and 'as
built' accessory deck, at; 1) addition and `as built' deck addition less than the code required minimum
side yard setback of 10 feet, 2) addition and `as built' deck addition less than the code required total
side yard setbacks of 25,feet, 3) `as built' accessory deck less than the code required minimum side
yard setback of 5 feet, located at: 1040 Holbrook Lane (adj. to West Branch of Mattituck Creek)
Mattituck, NY. SCTM#1000-113-6-13
The application for a second story addition/alterations to existing single family dwelling is recommended
as CONSISTENT. '
It is my determination that the proposed to legalize `as built' deck addition and `as built' accessory deck,
at; 1) addition and `as buift' deck addition less than the code required minimum side yard setback of 10
feet, 2) addition and `as built' deck addition less than the code required total side yard setbacks of 25
feet, 3) 'as built° accessory deck less than the code required minimum side yard setback of 5 feet is
INCONSISTENl'with the below listed LWRP polices and therefore INCONSISTENT with the LWRP:
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."
The as built decks were constructed without the benefit of a Zoning Board of Appeals and/or Board of
Trustees review or determination.
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Office Location: o���F $Q(��.yOl Mailin�LAddress:
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 D 15 � �S li 1J �
BOAItD OF APPEALS �UL 2 � 2015
TOWN OF SOUTHOLD
Southolc'Fown
Tel. (631) 765-1809 Fax(631) 765-9064 Planning Doard
July 22, 2015
Mark Terry, Principal Planner
LWRP Coordinator
Planning Board Office
Town of Southold
Town Hall Annex
Southold,NY 11971
Re: ZBA File Ref. No. # 6881 CACCHIOLO, Susan -
Deax Mark:
We have received an application for second story additions and alterations to an existing
single family dwelling. A copy of the Building Inspector's Notice of Disapproval under
Chapter 280 (Zoning Code), and survey map, project description form, are attached for
your reference.
Your written evaluation with recommendations for this proposal, as required under the
Code procedures of LWRP Section 268-SD is requested within 30 days of receipt of this
letter.
Thank you.
Very truly yours,
Leslie K. Weisman
Chairpe on
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SECTION NO
/� PROPERTIES NOTICE < < � �` �`� �`�-� 113
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� 11THOUT YRITTEN PERWSSWN OF iHE
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FORM NO. 3 1
. TOWN OF SOUTHOLD
\` f BUILDING DEPARTMENT
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
DATE: June 12, 2015
TO: Robert Barratt (Cacchioli)
4295 Vanston Road
Cutchogue, NY 11954
�
Please take notice that your application dated Mav 18, 2015
For permit to construct a second storv addition/alterations to an existing sin�le family dwellin��and
le�alize an "as built" deck addition. and "as built" accessorv deck
Location of property: 1040 Holbrook Lane, Mattituck, NY
" County Tax Map No. 1000 - Section 113 Block 6 Lot 13
Is returned herewith and disapproved on the following grounds:
�" �', The proposed construction on this non-conformin� 14,520 square foot lot in the Residential R-40
�;�` District, is not permitted pursuant to Article XXIII, Section 280-124, which states that on lots
measurin� less than 20,000 square feet in total size, the minimum sin le�s�ide yard setback is 10 feet
and the minimum combined side yard setback is 25 feet.
Following the proposed construction,-the dwelling will maintain its sin lg e side vard setback of+/- 5
feet and its existing total side vard setback of+/- 11 feet. The "as built" deck addition is noted as
havin� a sin�le side vard setback of+/- 9 feet and a total side vard setback of+/- 21 feet.
Furthermore, the "as built" accessorv deck, located in the rear of the nroqertv, is not permitted
pursuant to Section 280-15.which states that, on lots measuring less between 10,000 and 19,999 square
feet in total size,the minimum required setback is 5 feet.
This Notice of Disa roval was amended on Jul 16 2015 followin ' ion of new surve
which showed numerous "as built" structures.
uthorize Signature
Cc: File, ZBA
i
� t
: t��
� ,� Fee:$ Filed By: Assignment No.
� �
APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS
-- � �AREA VARIANCE
House No. Iv4� Street HOL/32Ao K �An�e. Hamlet MA�r� TvC 1�
SCTM 1000 Section ��3 Block 6- Lot(s) 1� Lot Size o�3�2 a� Zone ���
I(WE)APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR
DATED ��1�-�Is BASED ON SURVEY/SITE PLAN DATED � ��'t R 3 *:sl��f t5
�
Owner(s): S v S r4 IV C q C C F� l O�„�
Mailing Address: Z 3 Zo N F�fz�Z./� G� rq�1 S E T r4 V�, �E/�►�RA, ��Y I I 7 83
Telephone: �16-�82£��,.S�Fax: Email: sc. �.� �7 (�nol.co�
. 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: ����-�"' �S<+���' PE for(►�Owner( )Other:
, Address: 4Z4 'S 1rAi91� fi"�n1 t�t� , CuTcat� qv� �Vy l/R3�
�
1 � i Telephone: b'�1-734.273o Fax: Email: ►''ob�ev��.bqv�r�.�-t� o p�'c+���.;,�a, , ILa.�
Please check to specify who you wish correspondence to be mailed to,from the above names:
( )ApplicantlOwner(s), (✓)Authorized Representative, ( ) Other Name/Address below:
WHEREBY THE BUILDING INSPECTOR REV�WED SURVEY/SITE PLAN
, DATED � � I'Z- � l�"a and DENIED AN APPLICATION DATED 5��$� � S FOR:
(�)Building Permit
_ ( ) Certificate of Occupancy ( )Pre-Certificate of Occupancy
, ( ) Change of Use
( )Permit for As-Built Construction
( ) Other:
Provision of the Zoning Ordinance Appealed. (Indicate Article,Section,Subsection of Zoning
Ordinance by numbers.Do not quote the code.) '
Article: x�c ��i Section: z-80 Subsection: 12c.f
Type of Appeal: An Appeal is made for:
(.� A Variance to the Zoning Code or Zoning Map.
( )A Variance due to lack of access required by New York Town Law-Section 280-A.
( )Tnterpretation of the Town Code,Article Section
( )Reversal or Other
A prior appeal (,� has, ( ) has not�been made at any time with respect to this property,
� � UNDER Appeal No(s).#� 1315 � 101�Year(s). l�� 0 � IalS . (Please be sure to
�. t , research before complettng this question or ca!!our office for assistance)
' y� Name of Owner: W�c.�t A r►� g2oC�c N�2 ZBA File# 13�S �f���0
ALg�121' RovN'i2�.E �O 11 4 �10 �"1$
, ���
- Name of Owner: ZBA File#
{'
��' :'i REASONS FOR APPEAL (Please be specifrc, 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
propertiesifgranted,because: T�.c� v�Posao CHANq� �NLAVLC�ES �'K� -rwo ���sT ���oMs
F3y �.zS g f�.�yv-+�r-e-��n1 TH� EXIS�r� NC� F�2S'T FuuioR�o-�Vq�Nt' . Q{��riJE�/Eq„PARZ oF T HE
Rooa - ��aE. r�vsT B� Rw�sE,p gy (o ' 70 2�� A�ov£ GQ.�aD� a►a T+�E •_N�ar�� SipE
o a -f rtE 1-Fa o s t,1 sl o Rb E ri. To R Rfl v�oE TtF E R.6�c,71 R6�p FtE�1'V�R.00 rv�.
%H.g Q�pUcT(ON !N TtfC 517.� OF Tft� �S- 8ui[..y D�CKS c,.�tc,c, pt�ziviT TME'y
"�o �0�1�o2M ?o TFfE Sl�UC S E T-!3!}CK "Zo N��•+q �2.r,�tES
2.The benefit sought by the applicant CANNOT be achieved by some method feasible for the applicant to
pursue,otherthan , : A �doF- l,�rvE�uR�IAn�CE� gEcavsE ' "r�+Er�R�+oi-._,,,
MUs�t BE Rq�sE� •To• P�tav�o� SuF��GiL�J-? HE19�-- �mon�. 1'wou�.p LtKE
To NQ oT� TH wr TH E Z(�s�To 1!EE �t�4 K FQpM N RTV 2a�L. C�2r4�� 1 t �K.
L�'s c TH A�+ TN cs' KGSTfit�Tlo�1 Fo rt.. �,� �,t,,,,�„�` S�.a G�C F�A M l�+�/ �ko wt� .
3.The amount of relief requested is not substantial because: T►+e g���D�n�c, i s wE�,t. w,TH,.�
Bv��.aiNS �iC'iqr�T 1�Ed1��rtEnn�,,Ts An�C ANy SHADoW�n�` E�`FEc'is
.. A2E M�N�/+'+ql. Sr�rc� TH�y 'a�o NaT A����c.T Rwy A1�JvS�:n.�T v��4NaoRs
Sv��n,Nc,s stQaiF,caar��l,
4.The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the
� , neighborhood or district because: s�e. C37 4�ovE
�� ti
`_= �
5.Has the alleged difficulty been self created? {x} Yes,or { } No Why: L ari5�rZ BEnRo o M S
COU�,� NAV( q�N INGOlLPoC�ATt,� DV�lIN S �N �jl!}L G ONSTRVC�I�N
O 1=- T1tE 1-Fo ME I 1J 1 q 70 j3VT W AS N O'{ S V G Ct�STE� f}T TH'A"1' TIMt,•
Tlf� aEcKs C..�Fp.� /.��_ J3u��T
Are there any Covenants or Restrictions concerning this land? �v}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. ._
.—
Signature of Applicant or AuthoriZed Agent
(Agent must submit written Authorization from Owner)
Sworn to before me this��day
of SU f1 P .20�_.
�' Notary P ic
!
�
��° - ` TRACEY L. DWYER
'" 'NOTARY PUBLIC,STATE OF NEW YORK
NO.01 DW6306900
' QUAI.IFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,?,Q�
,-f<F:,_, _ � _ ' - ,
_ ��,�
APPLICANT'S PROJECT DESCRIPTION
- APPLICANT: Sv S A N G a c c� � o�.1 , DATE PREPARED: 6I �� I 's
r .
' - - 1.For Demolition of Existing Building Areas
Please describe areas being removed: I�ra�o2 ��s..c_.� Ai�o�Roo F �o��:��Ris���+� s�e.o N�
F'LOo 2 F�D�LooM S R�Jp F34Tµrt�oM.
II.New Construction Areas (New Dwelling or New Additions/Extensions):
Dimensions of first floor extension: t�►oN� , �s E E x�s T�N c, F�rzs�c Fuoo�c..
, Dimensions of new second floor: 24 � 2 4•�'
Dimensions of floor above second level: u N,— Ft N t s��o A-�`ri c. zc{ ' K z 4•6'
Height(from finished ground to top of ridge): Z�+s'
Is basement or lowest floor area being constructed?If yes, please provide height(above ground)measured from
natural existing grade to first floor: .�
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:7.�1'o f-r�o.is;�"°� F�oo,r�, �.oNTA�u.c -•
�
�� oNE S-raia vaB��-� oNE BPTHIC.00M P4Nn Tw� g' K9' C�vEST �£D -tt,00�ns
Number of Floors and Changes WITH Alterations: �o Fc:oores� �-h°�FLo02 Co NTA/�7S STA12-wEu. 1�ND BATF}-
-RooM 1�Np TW�O IS� %I2•3� �VEST 1��8- R:avPoeS �„vafY�tai� 8y �7�bs1 S�CORat�' `Loo�. ��?
•, A,�p E�r�-rua�. r�wrp �►vT�.vo�, aa��s vNe�.2 � NEw Z4�X zu•6' Roo�/�rr,c. s�E D�aq
�
N. Calculations of building areas and lot coverage(from surveyor):
Existing square footage of buildings on your property: 2 i z�
Proposed increase of building coverage: �r oN�
Square footage of your lot: I 3.q 35
Percentage of coverage of your lot by building area: 1�5���a a�°'o �
V.Purpose of New Construction: To tN�a,►zq c. r.��s S��c, G v Es�- &E�c�.�ti na c.,
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):
e �S'Df�o� S L,oP�. To Mf>'1'TITt1C.K ^G.�z�.EIL ' 1�,
• TFFI(AEi..'�' �RV1C...`ean� G �11`��C�5T: CArzaS� � {ipvr� � FK£p
• THE C..r►N D CoNTO v 2S Ao NoT �F�E�-r ['N L.A24�N�j THE GuEsr �p��Ms
S�Nc� We'. AaE wo�+ciro� werH�� T� Ex�srr•.�� FncsTF[�oo�c Foo-r—P2��,T
A*�D �ouN�qTtoN$
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.
f t
-- 4/2012 �
. "t� ' ; , r
► .-:. 3,1
��" QUESTIONNAIRE
FOR FILING WITH YOUR ZBA APPLICATION
A. Is the subject premises listed on the real estate market for sale?
Yes ✓ 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? Y�s
2.)Are those areas shown on the survey submitted with this application? �'Es
3.)Is the property bulk headed between the wetlands area and the upland building
area? `N o ' r-� - � • ' �� �— �,�
4.)If your properiy contains wetlands or pond azeas,have you contacted the Office of
the Town hustees for its determination of jurisdiction? �S Please confirm status
of your inquiry or application with the Trustees: sq�UTH o21ZAT1oN '�q(pS o�cc� 1�s.r���q2,
and if issued,please attach copies of permit with conditions and approved survey.
D. Is there a depression or sloping elevation near the area of proposed construction at or
' below five feet above mean sea level? t�o-
E. Are there any patios, concrete barriers,bulkheads or fences that exist that are not
shown on the survey that you are submitting? 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 construction taking place at this time concerning your premises? NO If
yes, please submit a copy of your building permit and survey as approved by the Building
Department and please describe:
G. Please attach all pre-certificates of occupancy and certificates of occupancy for the subject
premises. If any are lacking, please apply to the Building Department to either obtain them
or to obtain an Amended Notice of Disapproval.
H. Do you or any caowner also own other land adjoining or close to this pazcel? N o
If yes, please label the proximity of your lands on your survey. �
I. Please list present use.or operations conducted at this parcel 5+•.►Ci-E�� cw��,�y• Hd�sE
Q"caa-a►tiE , �Mtur*��ooc� ' "and the proposed use ExiS'�'�n+c, sIMGI.E� FAM�I.y�
AttOPOS��� SAtit� W1TH GqrtqCt, q� S{i E p . (ex•existing smgte family,proposed same with
garage,pool or other)
r 6/���5�
[
Authorized signature and Date -
� '
l
/�
-- - -- – -- — -� -- _�-t -
FORM NO. 4 '
, r '' ,�•~�
, - TOWN OF SOUTHOLD
t BUILDING DEPAR'TMENT
t
, �1 Town Clerk's Office
�� Southold, PT. Y.
Certificate Of Occupancy �
No. �'2�9. . . . . . Date . .T.tm� 7 , 19 �1
�f8 we�t M�.11 Rd
THIS CER'TIFIES that the building located at �•d�►�. o�'� �I111�T� R.D.iif,Street
Map No. �. . . Block No. . �7c. . Lot No. �C�pC MNtt',ituck H.Y� .
conforms substantially to the Application for Building Permit heretofore filed in this o�ice
dated . ,Tw� 23 , 19 �'t� puxsuant to which Building Perrnit No. _ �� .
" dated . . F�b 2� , 19 74 , was issued, and conforms to all of the require-
ments of the applicable provisions of the law, The occupancy for whi.ch this certificate is
r-- issued is P��v�#$. !�te.#'1�uR1.3.y. dwe:.11n� . . . . . . . . . . . . . . . . . . . . . . �
''; The certificate is issued to Wi113.am B�t1�Ck11er . -Own�r . . . . - . _ . . .
(owner, lessee or tenant)
, of the aforesaid bwlding.
Suffolk County Depaxtment of Health Approval . �lay . 34. ��'�'�. . . .by. R. V��a .
x.use � t�c�+o w�.�k� t�a, t�rt � �t 5)
. . . .- - - . �M. ��. �._,,r .
, Building Inspector�
� J
;
. 1. . --
•-- -- - ----- - ---- --- — - .,-- ,-.��-------
, r
3. Noture of vrork (check which opp le): New iBuildirg Addi .. Alterotion _� Z`
. . , , .z........ ............... ._................ �-
Repoir .................. Remaval .................. Demolition............. . Other Work (Describe) ..... .
4. Estimated Cost ............_�_lSr 000--•............ . .....Fee ......... ...... _... .. ........................................
..... ........... ...-- •--•--.. .... ................
. .............•-�
'r"" � - � (to be poid on filing this �Ucatio�)
� �i. If dwelling, number of dweltinp units .........i...:......:.....Number of dwelling units on each floor ............................
, '� (f garage,number of tars.....................................................................».........................---.................................... r
6. If business, tommercial or mixed occuponcy, specify nature and extent of each type of use ............................
7. Dimensions of existing structures if orry:Frant.............. ......»... Rear ......:....... . pep� .....
Height ........................ Number�of Stories ......T,�.e�.��;'�'�z�ncttls`!.�►311..b: aoffioiiB�a......r...
Dlmensions of same structure with olterations or odditions: Front ... ....... ......... .
. ..... Rear ............................
Depth ................................ Height ............................Number of Stpries ................................
8. Dimensions of entire new construction: Front ...........?r�...��a............Reor.......2i�..�x.r.......Deptfi......��..��.r....
Height ....26..ft... Number of StorFes ........1}...........»............................................. .._.................._..:..............
9. Size of lat: Front......`�.S?...�.r..-- itear SZ.t.r.�..--f�............. pepth ...339��4..1.336 91 P
10. Date of Purchase ........A�arch .15� 1968..............Name of F ..�}yl�'„�Zlg�t• •••--.........
ormer Owner .. .........
11. Zone or use disirict 1n which premises are situated ..._......�A�..,�:e��'1..C�.r... ........ ..... ... .....................
�pp96lZ��fOr ��BclCt �
12. Does proposed corutruction violote orry zoning law, ordinance or regulcrtion? ..fe..����..................•-•-..........
13. Nome of Owner of premises ..����1�..����Address ...�� ,�R�f...►��.�`li4t...... Phone No. ��-���$. �
Nome of Architect .�?.`.�.�..u.�..�:�1?�1��:��l:...Address.67...P�T]2:'.At1�6....MYC..... Phone No.�-,a1.1..5_
Nomeof Contractor ..............................»...................Address .....................••----....
............. Phone No. .........._.........
PLOT DIAGRAM
: Locate clearFy ond distinctly oll buildings, vahether existing or proposed, cncl indicate dl set-hack dimensions from
pro,perty lines. Give-street and block �umber or description occording to deed, and s}�or�, street names and i�icate
whether tnterior or comer lot.
GI�
,,. \' " � � -
_ .� , � sPp$oxmnarE �.o�sTlont /l
1 OP 4lG�liT�GRI+� F�OVS� �4
� 7D '
� 3r
- .
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Y ir '
d " ' ' 3� �xtisr�H� �rwcrve� �
ar -
� �-----�__ ro de o■awwtK� • d '
v � "i16A 1 '* _
� `'--�---�.._ f.eu
� ni �2VCLGN�aR � r------ d' .
b O O ' t >
- �� -- -- ••1�=�, •- �t � - �J n�
' ' ����2E� 'r� -
. �
Z ev�oxi�qY■ ►ACpT10N
� ' or S�sr�oQ�K tiOVSe.
bGOL■ 1� � SO�
STATE OF NEW YORK, 1
COUNTY OF ......... ..................lS'S'
..���C.'���....V....•�}C;.u.:�.�.�t.�...... ...............being dul ond that
(Nart�of individuol s' nin y �`Of�� d�°� � �e �s the opplicant
�9 9 aPPtication)..
abovenamed. He is the ......... .........................................���.�ll.l.�.�il...........•--•.................. ....
(Cwrtracfor, ager�t, cocporote officer,.etc.j..............
of soid awner or rnyr�ers, and is duly authorized to perForm or hwe performed the soid work and to rrake a�d file
this applicafion; thot aN statemerrt; contaned iri this appliwHon are true to tF� best of his knowledge ond belief; ond
i" �~=ahe work will be perfo 'n the monner set forth in the opplicatiorr filed therewith.
, `to before me this ' -
�t0 �.....�.. day of ' ' ........ . •• 19- �� .. � t e
Notary Publit . . .......... ....�...... ...�n.r..� . .»�.................
... .. .. .
, .... ... ...... . . ....... ^h� (Sig�aturo of opplitant)
JERO►JIE GAIANTER
doterY 4�bllc.State of New York
No. 60�135II2i$
T�em�F.�ire Mar 30.97n�ty
- Foa�as xo. 4 . -- --� L�...�
�' � . .
TOWlv OF SOUTHOLD � ._..
BUTLUTNG DEPARTME1vT '
,J Town Clerk's O$ice '
'" -°' Southold, N. Y.
Certificate Of Occupancy
No. �6�33 . . . . . Date . . . . . . . . . . . . .3�tt3Q . . 19 . . . . 19.7�.
.,
vff Miller ROW.
THTS CERTIFIES that the building located at . .Pv�.R..Q.�i.(I�U►��a7,q�t�rr. ,R,d�treet
Map No. �. . . .. . . . Block No. . �. . . . .Lot N'o, .uX7t. . .Ma���tu�k.. NaY.. . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . .Feb • • • •1�4. ., 19 75. pursuant to which Buiiding Permit No. . .7.7.�SZ.
dated . . . . . . . . . . . )�i:��. . �?.. ., 19.�5., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is '
issued is . .Px�..v$��, ,garage , (accesaory .bld�) _ . . (ap�roved by Bd Appelas)
� - The certificate is issued to . .A�.bflX:�.$oLtntx�� . . . . . . . . . . Ottri�T. . . . . . . . . . . . . . . . . . . .
-��, (owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval �4.R... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
UNDERWR,ITERS CEftTTFTCATE NO. .N.R.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
HOUSE NUMBER . . .�pl�.p . . . . . . Street . . . P.vt. l�aad. #. .1�. . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.l)`'f \ _=�-�,� ,
Building Inspector
- _ i. 1i �. '�S a�....a a. -
.�,- - -
� _ - �/ � - - � < <:� 4�4
3. Nature of work (check which a�oble): New Buildin .C� Addi� Alterotion �
g•..... .......... _...........•--... .......... , ...
. Rertxnrol ....... Damolitior................. Other Work "�';, j
. Repair ................. ........... ... _................. �Desc....� ..... .
_...... ..
'l' ��f � �-._. ................•••----•npt�
` �•,4. Estimoted Cost .R�.t..7 a:�..................•-••.,._......fee .:..•••-•-.��....._. ...... ...................
1 • (to be paid on filing tfiis opplicofion)
� i -
� � �5, If dwelling, number of dwell�units ............................Number of dwelli units on each floor
ng ............................
Ifgorage,number of cars.... ....�Y�.................:....._..............................................................................................._ -
6. If business, commerciat or mixed occupancy, specify noture ond extent of aach fype of usa ............................
7_ Dimensions of existing structures,if any:Front............................ Rea� •--•............................ Dep#i ....................
. Height ........................ Number of Stories _....................................................................................,...........................
Dimensions of same structure wlth olterations or odditions: Front .................................... Reor ........................._..
Depth ................................ Height ............................Numbg�of Stories .................. �
..�.....-•-••
- 8. Dimensions`of entlre new construction: Front ......_...�-./Z...............Reor.......rr.�.%�......»....Depth..��'.............
Height ....1.-.(..�...... Number of Stories .....�'�`..............................•..... ........................._................ ..........
9. Size of lot: Front .�..0..� . ....................... Rear...,?r..,2.e.��..... Depth .�.:�..L..�............
10. Date of Purchase�...�..:�--r�..�.:.......................IVame of Fom�er Owner W.h.�!.C.w:... ........ ...................
. �7
11. Zone or use district in which premises ore situated ....R . �:`�».................................••-.........................
12. Does proposed constnution violate arry zoning 1aw, ordinonce or regulation: •-.�....-•..................................
13. Will lot be regraded...�]k�..'...........Will excess fill be remaved f premises: ( ) Yes l� l�lo
14. Name af Owner of premises.;M.:.•��!"�.�1..t�,�.�••----•••Addr+ess��•• Phone Na »....................
Name of Archttect . � . ...........................Address ...... ..». ....... Phone Na .......»............."
l�lome of C4ntroctor �c�►�!.... . . .... .-••-•........Address�f��y Rhone Na.?+��'�twlt./�
, PLOT DIAGRAM
�� Locote cleorly ond distinctly a11 buildings, whether existing or propoaed, and indicate all set-back dimensions from
property lir►es. Give sireet ond block rwmber or description according to deed, ond sfiow shett names ond Indicate
,nhether interior or�omer lot. �
.�✓r"'- - g'�S`t . �
� _
, � �f�'�./�
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`�'') � t o� -� �
,,� . —�r�� ,
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. , ,. , ; , . .
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_ ` ,` � � $
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K . �,.
. o• . _-
. - ,
STATE OF NEW YORK, !S 5 � �
COUN 7 O .............. %. .........f ' •----
.,,....:...��,�„��.t./�,y,•.\����t.......::......:...�:be�n9 duly s�vom, depos�s pnd�oys thot he is th opplicon�
� (Nome of nrdividual signing toh coct7 , .
above nomed. • '
Heis the ...................».._..................�-..4.=�..�•r.....-••......._....__..._..._.........--•••-•••-•••................................................................
(Coniroctor,ogent, corporote officer, etc.)
of soid owner or owners, ond is duly outhorized to perform or have performed the soid work and to moke ond file
_±his opplication; thot olt stoternerits ton3aihad in this appllcotion ara f�ue to the best of fiis krwwledge and belief; and
�� � t�r the work wilf be performed in the monner set forth in the opplication ffled therewith.
�. ;Nom to beforo me this
�Jotary Publi of �L..��.../..���h�ufily ---'........�n���'���::@.1Gc"I..Q���. ...........................
(Slgrwture of appllcont)
JUDITH T.BOKEN
�tolary Pubt.:,Slule of New York
r1o.62-0.3aa963 5„ffolk Co�n -
��+�1on�tpiros AMvrch 30. 19��
-- -- -- --,~r ----:--- - �I�
� � i
� FORM NO.4 '
,✓ i ' TOWN OF SOUTHOLD
__ BUILDING DEPARTMENT �
' .� OfEice of the Building lnspector
Town Half �
Southold,N.Y. '
Certif icate Of Occupancy
No. . . . .,14838. .. . . . . Date . . August ,26�. . . . . . . . . . . . . . .. 19$�.
.,
THIS CERTIFIES that tlie building . , ,Ac c es s ory. .She d . . . . . .. . . . . .. ... .. . . . . .
Location of Property 1080 Holbrook La:. & ,�1�, W�.ck„Rd;, , , , ,Mat ti tuck, , }V,.Y t ,
House 11%. Stneet �'S Hamle�
County Tax Map No. 1000 Section .1 13. . . ,,glock . . .�6. . . . . . .. ..Lot . . . . . . . . ... .. ... .
5ubdivision .. . . . . . . . . . . . .. . .. . . . . . . . . . . .Fi1ed Map No. . . . . . . . .Lot No. . . .. ... . . . . . .
� conforms substant�ally to the Application for Building Permit heretofore filed in this ofCce dated
� A u gu s t. 21 , , ,, ,, , , , � �9 .$�pursuant to which Building Permit No. .l 51.9.�7.. . . .. . . . . . . .
dated Augus t 26 , , lg 86 ��yas��ued,and conforms to all of the requirements
— - {
of the applicable provcsions of the taw.The occupancy for which this cert�ftcate is�ssued i� ... . . . . . .
� Accessory Shed
� • . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . �. . . . . . . . . . . . . . . . . . . .. . .. .::. . ... . . .
The certificate �s issued to . . , , _ Donald .F:_ Shaw &. Dorothy R. .Shaw . . . . . . . . . . . _
. . .fowner�(�A+k��{�x . . .
of the aforesaid building.
Suffolk County Department of Health Approvai . . . . . . . . . . . ��A . . . .. . . . .. . . . . .. .. .. . .. . .. .
UNDERWRITERSCERTIFICATENO. . . . . . . . .. . . . . . . . .N/A , , . , , , , , , , , , , , ,, ,. ,,, , , _ ,. .
��� avc.0�--
. .. . . . . . . . . . .Building.Inspector. . . . . . . . . . . . .
Rev 7/81
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'FORM NO. 4 ,
- TOWN OF SOUTHOLD
� ' BUILDING DEPARTI�NT
'" Jj Office of the Building Inspector.
� Town Hall
Southold, N.Y. �
CERTIFICATE OF OCCUPANCY
No Z-22253 Date APRII� 9, 1993
THIS CERTIFIES that the building ACCESSORY
I,ocation of Property I040 HOLSROOK AYENUE MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section II3 Block 6 Lot 13
Subdivision Filed Map No. Lot No.
,, conforms substantially to the Application for Buildinq Permit heretofore
filed in this office dated OCTOBER 19, 1992 pursuant to which
- Builcling Permit No. 21280-Z dated MARQi 23, 1993
" ) was issued, and conforms to all of the requirements of the applicable
prova.sions of the law. The occupancy for which this certificate is
issued is ACCESSORY SHED WITEI DECR & BOARDWALR ADDITIaN AS APPLIID FQR
The certificate is issued to CARQL BLASUCEI
(owner) '
of the aforesaid building. '
SUFFOLK COUNTY DEPARTMENT OF I�LTH APPRdVAL N/A
UNDERWRITEF2S Q?RTIFICATE NO. PENDING - APRIL 8, 1983
PLUMBEILS CERTIFICATIOI�I DATED NlA
S ilding Inspector
Rev. 1/81
F
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} � ; �� SOUTHOLD, NEW YORK �: ' � :
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�j:� `� �� PERMIT NO. . 4103 � DATE: .. ..12/17/92 _ � := � :
\ �� . . . . .. . . . r�
� ��}'`� ` ISSUED TO Pet�x. & Carol Blasucci � � '
� �. : ,,� j�t �`
; �� ;� ,�eu#f������t�t��t �� � `',`
( � � ° ��
: � �::
, ;�
' � �� Pursuant to the provisions of Chapter 615 of the Laws of 6; *;'
���,,,,D �-. the Stafie of New York, {893; and Chapter 404 qf the Laws of the �v �E '.t�
� `��� ; „ State of New York 1952; and the Southold 7own O�dinance en- � ,• -�
''' � ' ,� titled "REGULATiNG AND TF�iE Pl.AC1NG OF OBS7RUC710NS � ;�
'=� ' IN AND Ot� TOWN WATERS AND PUSLIC l.ANOS and the �� ;t r�
„ � � �:� REMOVAL OF SAND, GRAVEL QR OTHER MATERIALS FROM J �''�
�s ; `%� LANDS 11NDER TOWN WATERS;" and in accordance with the , � .=�'
�� .
/ �. % �� Resolutiop of The Board adopted af a meeting held on 12/17 . . � `'`'�
�' -� •:3
� � � �� !9 9�, and in consideration of the sum of $ 150.00 paid.�y �4 ' �, F
, \ � � � �� ` ,�-:
� � ' � � . Petex BlasucGx .. . . . . �r ,`
� ��� ��. �; �
� � ,� � k� -
� �`y • � � � • ��� of , Po�t Washington N. Y, and subject to the a, a� �?:�
' ti �' Terms and Conditions listed on the reverse side hereof, !�' ; ?�
� �� • :� � of Sout�old 7own Trustees authorizes and permits tlie foilowing: i' ; �;;�
;ts►�qv<. ,��
� • �, 4b A Grandfather Permit for 40'X5' dock, 12'X3' walk & 40'X5' �� ; ,3
I. y'':
:'.,� float in Howards Branch of Mattituck Creek. 4;� � -
�
\ < - r' i� � '
a 6
� � ; : `r a{I in accordance wi�h the detai(ed specifications as presented in �} 9 \.
,"� � ''+� the originating application, ` - , E�
� 4{� � ��� �
" � ,'r� '� IN W(TNESS WHEREOF, The said Board of 7rustees h�re- d`� `
_ � � "� by causes its Co�porate Seal to be affixed, and,these presents to j� ��
- � ;� �.:
� �� :j be subscribed by a majority of the said Boa�d as of this dat,e. "
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- , TowN oF soaTeor.u, xsw Yoss DATE AIJF��•-•�LO� 1975
t
�
_ ACIION OF THE ZOMNG BOABD OF ApPEALS
�
Appeal No. 2Oj1 nacea February 24, 1975
ACTION OF TFIE ZONING BOARD OF APPEALS OF T'HE TOWN OF SOIJTFIOLD
To Chester Orlowski a/c Albert Rountree Appellaat
235 Pequash Avenue
Cutchogue, New York
at a meeting of the Zonlug Board ot Apyeals on April 1�� 1975 the appeal
was consldered and the action indlcated below was taken oa Your
( ) Aequest for vaziance due to lack of access W yroperty
( ) Request for a speclal exception under the Zoaing Ordinance
(}{) Request for a varlance to the Zoning Onllnance
( )
1. SPECIAI,EXCEPTION.By resoluUon of the Board it wes determined that a special �ceeption ( ) be
graaled ( ) be denied pursuaat to Article ..............._._Section ..........._....... SubsecLion .. pazagraDh
.... ......... ol the Zoning Ordinance and the declelon ot the BuAding Insyector ( ) be reversed ( ) be
confirmed because 8:05 P.M. (E.D.S.T.) upon application of Chester
Ozlowski a/c Albert Rountree, 235 Pequash Avenue, Cutchogue,
New York for a variance in accordance with the Zoning Ordmnance,
� Article III, Section 100-32 for permission to construct garage
in front yard area. Location of property: R,O.W, off Miller
R.O.W., Mattituck, New York, bounded on the north by Private
Road; east by D.F. Shaw; south by Howard's Branch of Mattituck
Creek; west by G.W. Argentieri. Fee paid $ 15. -
1
2 VARIANCE.By resolution of the Board 1L was determ�ned that '
(a) StrEct appllca4on o(the Ordfnance (would) (would not) produce practical difticulties or unnecessary
hardship because
SEE REVERSE �
�
(b) The hazdship created (is} (is not) unique and (would) (would aot) be shared by all properties
aLke 1n the immedfate vlcinity ot thls property and in the same use distrlct becatue
_ SEE REVERSE
(c) The variaaca (does) (doea not) observe the apirlt of the Ordinance and (would) (would not)
change the character of the dlstrict because
SEE REVERSE
and therefore, it was turther determined that the requested varisnce ( ) be granted ( ) be denied and
that t6e previous decisions of the Bu�ding Inspector( ) be rnnfirmed ( ) be reversed.
SEE REVERSE
7ANING BOARD OF APPEAIS
FOftM ZB4
{' ` Betty e e, Secretary Pro Tem .
_ Southo d Town Board of Appeals
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After investigation and inspection the Board finds that the
applicant proposes to construct garage in front yard area. The
Board finds that the applicant is the owner of a long and narrow
� lot. Applicant's house takes up almost entire width of lot
� . making it impossible to run a driveway to the rear of the lot.
� Other houses in this vicinity have similar garages in the front
yard area. The Board ayrees with the reasoning of the applicant.
The Board finds that gtrict application of the Ordinance
would produce practical difficulties or unnecessary hardship;
the hardship created is unique and would not be shared by all
properties alike i.n the immediate vicinity of this property
and in the same use district; and the variance will not change
the character of the neighborhood, and will observe the sptIIit .
of the Ordinance.
On motion by Mr. Hulse, seconded by Mr. Grigonis, it was
RESOLVED Chester Orlowski a/c Albert Rountree, 235 Pequash
Avenue, Cutchogue, New York be GRANTED permission to construct
` qarage in front yard area as applied for on property
located on R.O.W. off Miller R.O.W., Mattituck, New York, subject
to the following conditions:
That the garage be located no closer than 32 feet to
the R.O.W. (Bunqalow Lane) and no closer than 7 ft.
to the westerly sideline and 3 feet to the easterly
sideline.
Vote of the Board: Ayes:- Messrs: Gillispie, Grigonis,
Hulse, Bergen, Doyen.
* * *
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TOWN OF SOUTIiOLD,NEW YORK nn'rE ��]��p,d,�y 19,I970
� ACTiON OF THE ZO.*iIJtG BOAHD OF APPEALS
� � Appeal No. �,315 Daled January 29, 1970
ACTION OF THE ZONING BOARD OF APPEALS OF THE TOWN OF SOUTHOLD
To Martin U. Michaelis a/c William Bruc3cner Appellant
67 Park Avenue - 75 Henry 3treet '
New York, N.Y. • Brooklyn, N.Y. _____
at a meet�ng ot the Zoning Boazd ot Appeals on F0brU3ry 19� 1970 the appeal
�vas considered and the action i¢dicated below was taken o¢ your
( ) RBquest for variance due to lack ot access to property
( ) Request for a specisl exception uader the Zoning Ozdmance
Q[) Request for a varlaace to the Zoning Ordinance
( )
1 SPECIAL EXCEPTION By resolution ot the Board !t was determined that a special exception ( ) be
gr�nled ( ) be denied pursuant to Article ................... Section ...»...... ..... Subsec2ion .. __... ..... paragraph
.......�....... oL the Zoning Ordinance and the decision ot the Building Inspector ( ) be mversed ( ) be
conLrmed because 7:45 P.M. (B.S�T.)� upon application�of Martin U.
Michaelis, 67 Park Avenue, New York, D1.Y. a/c William Brucicner, '
75 Henry 8treet, Brooklyn, N.Y., for a variance in accordance
with the Zoning Ordinance, Article III, Section 307, for per-
mission to bu11d new one family dwelling with reduced sideyard
area. Location qf property: private right-of way off east s3.de
of West Mill Road, Mattituck, New York, hounded north by !taldoi�
q�� �rivate road, east by W E Sander, south by Mattituck
- � _ Creek, west by C W Argentieri.
` j 2 VARIANCE. By resolution oL the Board it was determ3ned that
(a) Str�ct appluation of the Ordinance(would) (would not) produce practical ditttculties or unnecessary
" hardship because
SEE REVERSE
(b) The hardship created (ls) (is not) un(que and (would) (would no!) be shared by all properties
alike in the immediate vicinIty o[ thts property and in the same use district because
_ SEE REVSRSE
(c) The varlance (daes) (does not) observe the spirit of the Ordinance end (would) (would not)
change the c6aracter of the djstrlet because
SEE REVERSE _
and therefore, it was further determined that the requested vaziance ( ) be Branted ( ) be denfed and
that the prevlous decIsions of the Bullding Inspector( ) be conikmed ( ) be mversed.
SSE REVERSE
i'lf f KU Y E� ZONING BOARD OF APPEAT C
FORM ZB4
_ "� � _ Betty Neville, Secretary
3outhold Town Board of Appeals
' " � Cha man c o pp- �ls
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' � After investigation and inapection the Board fi.nds that the
applicant requests permission to build new one family dwelling
with reduced sideyard area. The existing structure is set on
the pr�perty line at the southerly end of the lot. Applicant
intends to construct new one family dwelling further north with
5 ft. sicle yards. This will improne the uae of the lot.
The Board finds that strict applicatioa of the Ordinance
would produce practical difficulties or unnecessaxy haxdship;
the hardship createc3 ie unique and would not be shared by all
properties alike in the immediate vicinity of this property
and in the same use district; and the variance will not change
the character of the district and will observe the spirit of
the Ordinance.
TF�REFORE, IT WAS RESOLVED Martin U. Michaelis, 67 Park
Avenue, New York, N.Y. a/c William B=12Ckner, 75 Iienry 3treet,
Brooklyn, N.Y., be GR.ANTED permission to build new one family
dwelling W3th reduced aideyard aaea on•p�operty located on
paivat� rightroE-rway off eastr side of West Mill Road, Hattituck,
New York, subject to the following eonditio�C: ,
. , _ ,
No Certificate of Occupancy shall be issued on the new
structure until the old structure is deinolished. -
Vote of the Board: Ayes:- Messrs: Gillispie, Bergen, Hulse. -
� ��
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�� AGRICULTURAL DATA STATEMENT
; � `� ZONING BOARD OF APPEALS
' TOWN OF SOUTHOLD
WHEN TO USE THIS FORM: This jorm must be compleled by the applicant for any special use permit,
site plan approval,use variance,area variance or subdivision approva!on property wilhin an agricultura!
district OR within S00 jeet of a farm operation located in an agricultural district All applications
requiring an agricultura!data statement must be referred to the Suffolk County Department ojPlanning
in accordance with Section 239m and 239n of[he General Municipa!Law.
1. Name of Applicant: S v s P,�J C A c�►-� �o�.�
2. Address of Applicant: �3� N A(Z2 A� q N S6 i Av c � S E A FoQp� t�y ►t-y 83
3. Name of Land Owner(if other than Applicant): �
4. Address of Land Owner:
5. Description of Proposed
Project: ENLaac,E Ejc�STrN�, SECoNn FcAo� �vcsT SE.o ��+sts
6. Location of Property:(road and Tax map r
number) �owo �o� grLoo�� l.,�an�2i SCTMtkl�oo_ ��3— (o — l3
7. Is the parcel within 500 feet of a farm operation? { } Yes {�.} No
8. Is this parcel actively farmed? { } Yes {y} 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
_. 1 _.
2. —
3. �—
4. — -
5. — �
6. �-
(Please use the back of this page if there are additional property owners)
_ �
�` �� . O(p / 22 / f�
Signature of Applicant Date
Note:
1.The local Board will solicit comments from the owners of land identified above in order to consider the efT'ect of the
proposed action on their farm operation. Solicitations will be made by supplying a copy of this statenent.
2.Comments retumed to the locai 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 ihe time the application is submitted for review.
_,
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617.20
Appendix B
�
Short Environmental Assessment Form
� Instructions for Completin�
Part 1 -Project lnformation. The applicant or project sponsor is responsible for the completion of Part l. 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.
Compiete ali items in Part I. 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 Svs�►r.� c Acc�.1�o�.�
�-3�� N AR2A G Arv�„S,E�i A vE � g�FOQo N y 1•l'7 83
Name of Action or Project:
ENc�s�vr�t "r►,�o c.v�s-r SED 2aoms W��Hi�1 6x�$�ri►•�c, F�o�rPa.�►�r•
Project Location(describe,and attach a location map):
�oc�.o H�c.Srz,cok �� E , nn�e►-t�-►TUC1� NY , ScTrq�# IooO— 1�3—�-13
Brief Description of Proposed Action: ' ,
REMo�E PAa_T o� R.00F ANt► SEcon�� �wotL wra�.�.S
R�-gL11LD ?f}G T�O �UQ-r ��P�/ZpOM1'► �7StNC� L,�i2C�1+l.. D�ro+iNr�aas
RE-F3uu.c Roo� q,.r o S�cao�.-f $TRVCT�A-E _.
'�,E-�F�t�t�H ELECT2tc We�t1�7� � ►►JTt'4l�1AL. �Aws ANb C.Et�-R���
' ,�-_' Name of Applicant or Sponsoc R�P 4e SEN'��T�/� Telephone: 63�_�3u—��J 3a
�'Poa��' g AYL2A j 1 p� E-Mail: fob.nvt{oarra}� opto��ww�l�k
Address:
4'Z4S VANSTON 21p.�11�
City/PO: State: Zip Code:
c�,-rc«+mc,v� Ny It�3s
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. lf no,continue to question 2.
2. Does the proposed action require a permit,approval or funding from any other govemmental Agency? NO YES
If Yes,list agency(s)name and permit or approval: ✓
3.a.Total acreage of the site of the proposed action? o.3 z �r�
b.Total acreage to be physically disturbed? � acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsoi? v •3 z acres
4. Check all land uses that occur on,adjoining and near the proposed action.
❑Urban o Rural(non-agriculture) o Industrial o Commercial �Residential(suburban)
, ❑ Forest o Agriculture ❑Aquatic o Other(specify):
❑Parkland
� Page 1 of 4
_ _A 6.a
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? �
7. Is the site ofthe proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES
If Yes,identify: W ES�t 8 2�,N c t1 oF +�'�-0+�Tt ��v c�< «��
8. a.Will the proposed action result in a substantial increase in traf�ic above present levels? NO YES
✓
b.Are public transportation service(s)available at or near the site of the proposed action? �
c.Are any pedestrian accommodations or bicycle routes available on or neaz site of the proposed action? �/
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: Do►K EsT� c. w E`c. �
' 1 l.Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe met}iod for providing wastewater treatment: s�a'r'�c Ta�K �/
- -- 12. a.Dces 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 azcheological 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.Vliould the proposed action physically alter,or encroach into,any existing wetland or waterbody? �
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres:
. .��. -
;�
• � ;;-"
14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply:
_ C1�Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional
' ❑ Wetland ❑Urban ❑Suburban
I5.Does the site ofthe 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 ftom point or non-point sources? NO YES
If Yes,
a.Will storm water discharges flow to adjacent properties? ❑NO�YES �/
b.Will storm water dischazges be directed to established conveyance systems(runoffand storm drains)? �
If Yes,briefly describe: ❑NO❑YES
Page 2 of 4
� �� ���
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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 siie: �
_�a�
�
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
KNOWLEDGE
Applicandsponsor name: Iz�+3�-f f3 ra-�ri,Q�-� P C Date: �� �6/ 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] 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
, . '� . • i - . , i,�i;.,-:�•'?'"' small to large
_ _ , , ��'+ impact impact
_ , ' - - may may
'• ;.r.' occur occur
1. Will the proposed action create a material wnflict with an adopted land use plan or zoning r
- 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 traf�ic or
affect existing infrastructure for mass transit,biking or walkway?
, 6. Wilt 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. Wiil 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)?
r
i
Page 3 of 4
,
.: - 6. �
:.�-�,;
�� �
No,or Moderate
small to large
�' impact impact
' may may
f occur occur
10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage
problems?
11. Will the proposed action create a hazard to environmental resources or human health?
Part 3-Determination of signiTicance. The Lead Agency is responsible for the completion of Part 3. For every
question in Part 2 that was answered"moderafe to lazge 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 aiso 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.
�
o Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action may result in one or more potenrially large or significant adverse impacts and an
environmental impact statement is required.
❑ Check this box ifyou have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action will not result in any significant adverse environmental impacts.
Name of Lead Agency Date
Print or Type Name of Responsible O�cer in Lead Agency Title of Responsible Officer
Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer)
` Page 4 of 4
. . � �� �
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Board of Zonin�Appeals Application
AUTHORIZATION
(Where the Applicant is not the Owner) .
I S�4�N �aec H ioyt residing at Z32c NA1L0.A 4ANr&T A�� �
,
(Print property owner's name� (Mailing Address)
see►�.�q, iv y u7�� do hereby authorize �s6�T � 6w�i.c�rrr PE
(Agent)
•• to apply for variance(s) on my behalf from the
Southold Zoning Board of Appeals.
�'
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.
(Owner's Signature)
SV�AnI CA CC N 1�C.�
(Print Owner's Name)
� `
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�f 1 APPLICANT/OWNER ,
1,
TRANSACTIONAL DISCLOSURE FORM
� The Town of Southold's Code of Ethics arohibits conflicts of interest on the uart ot town ofiicers and emploYees.The purpose
of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whateper
action is necessarv to avoid same.
YOUR NAME: Sv s a ti+ c a c c r-�� o�.�
(Last name,rrst 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 evea a partial
ownership of(or employment by)a corporation in�vhich the town officer or employee owns more than 5%of the
„ shares.
YES NO ✓�
If No,sign and date below.If YES,complete the balance of this form and date and sign where indicated. �
� � Name of person employed by the Town of Southold
1.
� ' Title or position of that person �
Describe the relationship between yourself(the applicant/agenUrepresentative)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
r
D)the actual applicant
DESCItIPTION OF RELATIONSHIP
Submitted this�day of ,20�
,.- _ Signature
� 'i
_ PrintName �v�p►� �4�C Mto� �
�f�.
��
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a
f` � AGENT/REPRESENTATIVE
�, �' TRANSACTIONAL DISCLOSURE FORM
,
The Town of Southold's Code of Ethics arohibits conflicts of interest on the part of town ofiicers and emplovees.The purpose
of this form is to arovide information which can alert the town of possible conflicts of interest and allow it to take whatever
action is necessarv to avoid same.
YOURNAME : K��t�T E3r�a►cr;fa�-i PE
(Last name,Tirst name,middle initial,unless you are applying in the name of someone else or other entity,such as a
company.If so,indicate the othcr person's or company's name.)
_ TYPE OF APPLICATION: (Check all that apply)
Tax grievance Building Permit ✓�
Variance Z bA ✓ 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 oRcer
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 ofiicer or employee has even a partial
ownership o!(or employment by)a corporation in which the town officer or employee owns more than 5%of the
shares. �
- YES NO ✓
If No,sign and date below.If Yes,complete the balance of this form and date and sign where indicated.
� Name of person employed by the Town of Southold -
t' �°~'� Title or position of that person
Describe the relationship between yourself(the applicanUagenUrepresentative)and the town officer or employee.
Either check the appropriate line A)through D)and/or describe in the space provided.
The town otficer 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 �/ day of .��,20 /�
,. - Signature �_��_ �
, �
' � Print Name ��_T ��rzrZAT r
Town of Southold "�` - �/'
_ ,
LWRP CONSISTENCY ASSESSMENT FORM
. j
-" 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
Water&ont 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. lf any question in Section C on this form is answered "yes", then the proposed action may affect the
achievement of the LWRP policy standazds 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 librazies and the Town Clerk's office.
� B. DESCRIPTION OF SITE AND PROPOSED ACTION
SC'TM# ��� - l 13 - �— 13
The Application has been submitted to(check appropriate response):
Town Board � Planning Dept. 0 Building Dept. � Board of Trustees 0 Z g � r " '
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:
ENLARCE TV.90 B�02AOM� 01�1 SINC�(..£ FAM�L�I HOMt .
�' ` . `7"�/KS" WIG.C. /NC2���, TH� �OOF ,Li/N� ELEv'F�7lL7N �K
1
. T� 2�� ON A- %/�O N - CO N I�-O!�I✓I(N S ,�j� ./-�GY��20 l!�'Q /N ATTAC ff�r0
<FcTion�r /3i�'' !�y-e'tf- i�z9��o � �Aii ��4TE,D ��2S��7S.
��
: q-�,
�
_ �,
.
-. Location of action: (04o f{.o�,S Qoo�G �E � M q'i'7'i i'v C�L
�
—`� ' . Site acreage: 0• 3 • �
Present land use: SiN4�,E FAMI�.�/ livrH�
Present zoning classification: R 4-0
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: Sus�n, C acc�+�o�-�
(b) Mailing address: 'Z3�o N A2lZA G'A�1S E? av�'
SEAFo¢t� h1y I1'1 s3
(c) Telephone number: Area Code( ) (Si 6>$zG. — 3�,SS
(d) Application number, if any:
Will the action be directly undertaken, require funding, or approval by a state or federal agency?
Yes ❑ No� If yes, which state or federal agency? -
" ; DEVELOPED COAST POLICY .
Policy 1. Foster a pattern of dev�lopment in the Town of Southold that enhances community character,
preserves open space, makes efficient use of infrastructure, anakes beneficial use of a coastal location,and
minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation
criteria.
a Yes � No � (Not Applicable- please explain)
_ �NLFF2QIAf5 ?4�t. Ct��ST BED2ooM S[Z$S Wlc.c. ENco.,��aG� THt� Own�QZ Tv
� USE Tr+E Ht�Mt �`�+oQE o�7'E�J To Ttfs BEniE•=,T pc TH-� 7aw�l
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See
LWRP Section III—�olicies Pages 3 through 6 for evaluation criteria
0 Yes � No 0 (Not Applicable—please explain)
� � S�E"E�� .Pe�<-tay / � .4�Ov� ' ' � . "
��
,�>
:��"3
, 9-3
� Attach additional sheets if necessary
�� -
� -� Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold_ See
LWRP Section III-Policies Pages 6 through 7 for evaluation criteria
� Yes 0 No � (Not Applicable-please explain) �
7ff� e�c RTi o n! o�-�'t�� ,�l��-t L BE'rt��/� ; �TffE: -�'-r f�2 q�C, �i/N�/►��€�',s� :
f�N� t�GQusf,L /MP!}cT c., �
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 � No � (Not Applicable-please explain)
ENLARe1N� T�Fi�. S�,�otJD FL�oo2W��NiN 7ifE FIR3T Flme2 FpoT- P�y�N�(' t,�i�,�,
HAV�E ,M�rv�mqL. E FFL- �T o^i Th�Es� Fs�cro�2s
; t
� �
�- -
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
� Yes 0 No 0 (Not Applicable-please explain)
- W�'�7L s�v1cES Ars.� NoT G Ht�Nt�� p
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 a No� (Not Applicable- please exp�ain)
' , SEE� .Ro�.�cY 4 �n►s .ASov�
_. '
a��
t ',
-- 'J
Attach additional sheets if necessary �
Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — P�cies
Pages 32 through 34 for evaluation criteria. See Section III—Policies Pages; 34 through 38 for eval�tion
criteria.
� Yes � No� (Not Applicable—please explain)
St�E Po�tcY 4 F�'F�vE
Attach additional sheets if necessary
. Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazau�dous
substances and wastes. See LWRP Section III—Policies; Pages 34�through 38 for evaluation criter�.
0 Yes ❑ No 0 (Not Applicable—please explain) _
� -' SEE Po��cy 4 ABovE
PUBLIC COAST POLICIES
Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and pt�blic
resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation
- criteria.
� Y� No� (Not Applicable—please explain)
seE Pou�� 4 I�soYE
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.
r
�
,� - �� � Yes ❑ No � (Not Applicable-please explain)
� pd���-y 4 A�ovE
Attach additional sheets if necessary •
Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic
Estuary and Town waters. See LWRP Section III-Policies; Pages 57 through 62 for evaluation criteria.
.
� Yes ❑ No� Not Applicable-please explain
sEE P��tG-•.{ 4- ��c��t�,
Attach additional sheets if necessary
Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section �II-Policies; Pages
�
, - ., 62 through 65 for evaluation crite�-ia.
--�'`�
0 Yes ❑ No� Not Applicable-please explain _
SL� �4 4-1�Y � � ��'�l�
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 6$ for evaluation criteria.
0 Yes ❑ No � Not Applicable-please explain
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the easterly neighbor's house to left and the subject house garage to the right
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_ Mr. Robert Barratt PE, 4295 Vanston Road, Cutchogue,NY 11935
Telephone 631734 2730, Email: robertbarratt@optonline.net
The Zoning Board of Appeals(ZBA)
Southold Town Annex
Southold,NY 11971
Delivered by hand July 21�`,2015
Subject: 1040 Holbrook Lane,Mattituck,NY
To whom it may concern,
The owner Mrs. Susan Cacchioli and I prepared a building permit application to enlazge the two
second floor bedrooms in the subject property. This involves raising that part of the roof to
26.Sft,while maintaining the existing foot-print of the house.as shown on the survey and the
� proposed building plans.
" However the permit application was disapproved by the Buildi.ng Dept since the house is located
on a non-confornung lot and their review of a current survey also shows the lot contains two as-
built decks which violate the planning side set-back rules.
, � The owner has agreed to amend the proposed building plan to include reducing the size of the as-
'�,-=� built decks and modify some associated windows. The up-dated building plan,other support
documents and my owner's check for$1000.00 aze attached.
The table of contents for the documents is a follows:
1. Application -
2. Project description
3. Questionnaire
� 4. Pre-CO's, CO's a11 prior ZBA decisions
5. Agricultural data statement, answers 1-8
6. Short EAF four pages
7. Owner's consent '
8. Transactional disclosures owner and agent
� 9. LWRP Form
10. Photos
11.New Survey
12. Building plan sheet 1 and 2
13. Town property cazd
Respectfully submitted,
; -
� - Robert Bazratt PE
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Source Documents: o - ; c � _
Land Surveyor: Nathan Taft Corwin III - _���,""�v� " �- �
Survey dated luly 6,2015 ; m ME�'�ES��'� �r a ;
� Architect: Martin Michaelis 3/22/70 ; Qo'q� � �
Southoid Building Dept correspondence ' M A T T 1 T U C "b }
Southoid ZBA correspondence s=°°�_ �� ;
_� - �. _ 48 ��
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Notes: ' " '� �...,�.'�K= �
External wall studs,top piates, bottom piates all 2in x 6in 16in OC � s `
R
E� f
Corner wall studs 3(2inx 55in) � • '� ��� '
Rafters all 2in x 12in,16in OC �� � � � g 5 � g�T � �
, Lartrel �
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Room floor joists all 2in x 10in, 16in OC , La�e' '-' � .`•` ; i
Attic floor joists 2in x 8in,16in OC � N r.s. � p � , i
Plywood wall panel,internal wall cladding gypsum board all 5/8 in ' CONSER✓A _ � � ; i
AREA �� � .' rP` � • ` f
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All timber joints reinforced with 1.5in x 24in steel straps or equivalent l..o c o►t- MA P ti
Base and sill plates to be anchored using anchor bolts, max 60in OC , -
Window header2x2inx8inx4ft - ' �
Ridge board 2(2inx12in)
Sub-floor 5/8in plywood panels -
For all fasteners see building code table attached
Client's choice: . ,
Roof tiles,wall shingles,finish floor and style of windows
Client's decision: �
The client has proposed to reduce the size of the two as-built decks to the sizes shown on sheet 1, in ,
order that the decks will conform to the Southold planning guide-lines.It is understood that this work '
may require some minor changes to the first floor window arrangements.This work will be
accomplished while the bedroom expansion work is in progress -
,
. . ; Drawing#051715 Sheet 2 Rev 0 Date:07/20/2015
.: .�_ - - ; -
- _.;��CS'F N�El�yy , ." Title:General Arrangement proposed bedroom extension
. , ' �S�R��tZ�Q•B•q,Q Q'.Q�- ' Robert Barratt PE 4295 Vanston Road. CutchoQue. NY 11935,
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* �� -.�.� * , Tel 631 875 0275 robertbarrattC�optonline.net ,
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� .� � These ptans are an instrument of the service and are-the property of the design ;
��' . professional whose seal is affized hereto. Infingements will be prosecuted to the fullest ,
� ��Q81868' �� � � extent of the law. Contractor shall verify all field conditions and dimensions and be solely ;
v
SS respon�ible for field fit The design professional assumes no liability for omissions due to ,
• unknown or unforeseen field conditions and or additions based upon comments not �
7 ryO�I�• fortnally acknowledged as revisions to these plans. �
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UNAUTHORIZED ALTERATION OR ADDITION
TO THIS SURVEY IS A VIOLATION OF
SECTION 72D9 OF THE NEW YORK STATE
EDUCATION LAW
F�ME COPIES OF THIS SURVEY MAP NOT BEARING
SHED SHED 0 L THE LAND SURVEYOR'S INKED SEAL OR
8 1'
EMBOSSED SEAL SHALL NOT BE CONSIDERED
N TO BE A VALID TRUE COPY
rn
CERTIFICATIONS INDICATED HEREON SHALL RUN
SHED ONLY TO THE PERSON FOR WHOM THE SURVEY
�3'yy IS PREPARED, AND ON HIS BEHALF TO THE
TITLE COMPANY, GOVERNMENTAL AGENCY AND
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTI-
PATIO TUTION. CERTIFICA710NS ARE NOT TRANSFERABLE.
FLOATING DOCK 01'W
USED AS Pq7i0 THE EXISTENCE OF RIGHT OF WAYS
AND/OR EASEMENTS OF RECORD, IF
�o P9Tiw ANY, NOT SHOWN ARE NOT GUARANTEED.
00
PREPARED IN ACCORDANCE WITH THE M NIMUM
(�,� "�� STANDARDS FOR TITLE SURVEY ESTABZISH€p
w n � BY THE L I A L S AND APP j0 Fep �f,'[�A�T�Q�
� I o FOR SUCH USE BY THE EW�Y�3 �t9�
� TOP OF BANK I y N TITLE ASSOCIATION �,��° ,�������� �'
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WA�ER MARK��H
MARSI-I GRA55
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= N Y.S. Lic No 50467
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� Nathan Taft Corwin III
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, � Land Surveyor
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' ��J' �� �j Successor To Stanley J. Isaksen, Jr L S
�""1� TT���- r � °' �� �� Joseph A. Ingegno LS.
���-�1 �� Title Surveys — Subd�visions — Site Plans — Construction Layout
���. PHONE (631)727-2090 Fax (631)727-1727
OFFICES LOCATED AT MAILING ADDRESS
1586 Main Road P 0 Box 16
Jamesport, New York 11947 Jamesport, New York 11947
35-149
,