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HomeMy WebLinkAbout1000-59.-2-2 OFFICE LOCATION: �QF SO(/T�OI MAILING ADDRESS: Town Hall Annex ~ P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) ® Q Telephone: 631765-1938 Southold, NY 11971 �'o a Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Leslie Weisman, Chair Members of the Zoning Board of Appeals From: Mark Terry, Principal Planner LWRP Coordinator Date October 14, 2016 Re: Coastal Consistency Review for ZBA File Ref ABSOLUTE IMPROVEMENTS INC./JOHN COSTANZO #6988 SCTM# 1000-59-2-2. ABSOLUTE IMPROVEMENTS INC./JOHN COSTANZO #6988 - Request for Variance(s) from Article XXIII Section 280-124 and the Building Inspector's June 10, 2016, Notice of Disapproval based on an application for building permit to construct additions and alterations to an existing single family dwelling, at; 1) proposed additions located at less than the code required minimum rear yard setback of 35 feet; 2) proposed additions located at less than the code required minimum side yard setback of 10 feet; and 3) proposed additions more than the code permitted maximum lot coverage of 20%, located at: 80 Dogwood Lane (3200 Kenneys Road), Southold, NY SCTM # 1000-59-2-2. The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP provided: 1. Note the existing sanitary system is not shown on the survey. Verify if the existing sanitary system is functioning. An upgrade to the sanitary-system may be required to further Policies 5 and 6 due to parcel proximity to Great Pond. 2., Stormwater controls are not shown. Require compliance with Chapter 236 Stormwater Management of the Southold Town Code. In regard to the neighborhood character, due to the small lot size (9,449 sq. ft.), two front yards and historic build out of the neighborhood, it is my recommendation that the proposal is not discordant with the existing neighborhood character. 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: William Duffy, Town Attorney Office Location: QF $0�jyol Mailing 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 1yC00 ,�' a http://southoldtown.northfork.net BOARD OF APPEALS E V E TOWN OF SOUTHOLD D Tel. (631)765-1809 Fax(631) 765-9064 AUG � � 2016 August 17, 2016 Southold Fown planning Board Mark Terry, Principal Planner LWRP Coordinator Planning Board Office Town of Southold Town Hall Annex Southold,NY 11971 Re: ZBA File Ref.No. # 6988 COSTANZO, John Dear Mark: We have received an application to construct 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 268-51) is requested within 30 days of receipt of this letter. Thank you. Very truly yours, Leslie K. Weisman Chairperson I,n By: � FORM NO. 3 - TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL l DATE: June 10, 2016 TO: Absolute Improvement Inc. Po Box 446 Laurel, NY 11948 Please take notice that your application dated June 6;"2016 For permit to construct additions and alterations to an existing single family dwelling as applied for at Location oIpro perty: 80 Dogwood Lane Southold NY County Tax Map No. 1000 - Section 59 Block 2 Lot 2 C's r-e'i f� Is returned herewith and disapproved on the following grounds: The proposed construction on this 9449 square foot parcel with two front yards is not permitted pursuant to ArticleXXII1, Section 280-124, which states that on lots measuring less than 20,000 square feet in total size the minimum rear yard setback is 35 feet the minimum single side yard setback is 10 feet and the maximum lot coverage is 20 percent. The proposed construction notes a rear yard setback of 6.5 feet a single side yard setback of+/-4 feet and total lot coverage of 24.5%. , ------------ ---- -------- Authorized Signature Cc: File, ZBA Fee:$ Filed By: Assignment No. APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS AREA VARIANCE �,Jp House No. _Street �o y W�O d Hamlet Jaa w./'y SCTM 1000 Section _Block d- Lot(s) Lot Size �/ Zone I(WE)APPE L THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED ro /o J BASED /ON SURVEY/SITTEE PLAN DATED Owner(s): -/�°r� e% —.4ao, 09 le— Mailing Mailing Address: 41Z Telephone: 5/4- +a X: Email: J G l 4 -7 2- c,L rt 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: 4�1//-_i S A160 u nfor(V Owner( )Other: Address: �JSO S`✓'r' E/tG'/ >, r. A TT/7z.�Ze., �✓i/ /!JAS Z Telephoned/4' 3"f ff_72ffax: Z.?/-0?1/'�-�d i SL Email: 'ecl-'0 4 ae &&e- -, Please check to specify who you wish correspondence to be mailed to,from the above names: ( )Applicant/Owner(s), K Authorized Representative, ( ) Other Name/Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE VLAN DATED and DENIED AN APPLICATION DATED G is h 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: "�T Section: .2 6-0 / a? 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 required 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 any time with respect to this property, UNDER Appeal No(s). Year(s). . (Please be sure to research before completing this question or call our office for assistance) Name of Owner: ZBA File# Name of Owner: ZBA File# REASONS FOR APPEAL (Please be specific, additional sheets may be used with preparer's signature notarized): 1.An undesirable change will not be produced in the CHARACTER of the neighbor or a detriment to nearby properties if granted,because: V/// ©,9 r n y o { 1jvGs-e!V-S 1%7 .4 eft 2.The benefit sought by the applicant CANNOT be achieved by some method feasible for the applicant to pursue, other than an area variance,because: Gf c� n GL Zo csJi F✓�ti 3.The amount of relief requested is not substantial because: 'J ��.' �� • � o > �1� �-� — �vTii� Gam' Gv�r':s� 4.The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: E�R 5.Has the alleged difficulty been self crea ed? { } Yes, or {(No Why: Are there any Covenants or Restrictions concerning this land? fro { } 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 Authonzation from Owner) Sworn to before me this' day of '2o rMA2K Notary Pub c T.GI NOTARY PUNo.146S ate0f New YOtk Qualified in Suffolk County Commisslon Expires May 31, �Wl APPLIC''ANT'S PROJECT DESCRIPTION APPLICANT: —/® , _ —4 DATE PREPARED:W - 1.For Demolition of Existing Building Areas Please describe areas being removed: ���c.�C c_✓ �'�4�5 eft v U.New Construction Areas(New Dwelling or New Additions/Extensions): Dimensions of first floor extension: LU� 7 1, ®?A Dimensions of new second floor: Dimensions of of floor above second level: 12-X .2C Height(from finished ground to top of ridge): —:?v a Is basement or lowest floor area being constructed?If yes,please provide height(above ground)measured from natural existing grade to first floor: M.Proposed Construction Description (Alterations or Structural Changes) (Attach extra sheet if necessary). Please describe building areas: Number of Floors and General Characteristics BEFORE Alterations: .S; n Number of Floors addChanges WITH Alterations: IV. Calculations of building areas and lot coverage(from surveyor): Existing square footage of buildings on your property: 1 S',� Proposed increase of building coverage: Square footage of your lot: - '9 Percentage of coverage of your lot by building area: V.Purpose of New Construction: /� e, q-U&ye— ell'/ A,s 77v&-- V1. 7v&—VI.Please describe the land contours (flat,slope %,heavily wooded,marsh area,etc.)on your land and how it relates to the difficulty inmeetingthe code requirement(s): // Please submit 8 sets of photos,labeled to show different angles of yard areas after staking corners for new construction,and photos of building area to be altered with yard view. 4/2012 QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION A. Is the subject premise listed on the real estate market for sale? Yes VNo B. Are t e 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? k 1a 2.)Are those areas shown on the survey submitted with this application? 3.)Is the property bulk headed between the wetlands area and the upland building area? /1/d 4.)If your property contains wetlands or pond areas,have you contacted the Office of the Town trustees for its determination of jurisdiction? Please confirm status of your inquiry or application with the Trustees: 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? Al® E. Are there any patios, concrete barriers,bulkheads or fences that exist that are not shown on the survey that you are submitting? ,d Please show area of the structures on a diagram if any exist or state none on the above line. N. Do you have any construction taking place at this time concerning your premises? /y® If yes,please submit a copy of your building permit and survey as approved by the Building Department and please describe: G. Please attach all pre-certificates of occupancy and certificates of occupancy for the subject premises. If any are lacking, please apply to the Building Department to either obtain them or to obtain an Amended Notice of Disapproval. H. Do you or any co-owner also own other land adjoining or close to this parcel? /6� If yes,please label the proximity of your lands on your survey. I. Please list present use or operations conducted at this parcel and the proposed use (ex-existing single family,proposed:same with garage,pool or other) Authorize ignature andbate FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. . Z6.1.96. . . . . Date . . . . . . . . . . . . . . . . NOY b 19. . . . . . . . . ., THIS CERTIFIES that the building locatedat .,4pA J►. Road & ,Po9-Vopd Street Map No. xx. . . . . . . . . Block No:+ cX . . . . . . .Lot No. . .�. . . eoro�thold . A!,*. . . . . . . conforms substantially to the �SuM. faxllYdol Bt QOda Bu�lt bePor® �� date AWIX -Q, 19. .57, pursuant to which Car �f Z. 4 C� o. Z. .b1 dated . . . . . . . . . . . PQV. . . b. , ., 19.74., 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 ling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . .J.obii. Ji3, . . . . . . . . . . . . . . . .... . . . . . . . . . . of the aforesaid building. (owner, lessee or tenant) Suffolk County Department of Health Approval . . _ . . UNDERWRITERS CERTIFICATE No. .Axl-�XS1�j�?g. . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . . .3200. . . . . . Street . . .�Cexw,�y. .':4ad . . . . . . . . . . . . . . Building Inspect�r FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building tnspector Town Hall Southold, N.Y. Certificate Of Occupancy No. 21123 . . . . . . . . . . . Date . . . October,6 . . . . . . . . . . . . . . . . . . . . . . . .. 1982. THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . Location of Property 80 Aogwood-Lane•&•3200.Kenny .Road, .�outlaold. . . . . . . . . . House IV o. S;4treet �Nam/ei County Tax Map No. 1000 Section . . .059 . . . . . .Block . .02. . . . . . . . . . .Lot .002. .. . . . . .. . .. . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . .Augu4t; A4 . . . . . . . . . . . 1989. pursuant to which Building Permit No. .108332. . . . . . . . . . . . . . dated .Augur t.14. . . . . . . . . . . . . . . . . . 19 AO. ,was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . . . . . . . . .construct.accessory.staxage.bulldlug. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . .Henry.Beehler. . . . . . . . (owner,lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .N/A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . .NbA_ Building Inspector Rev.1/81 TS/T -AaH a.zng2 TS paZTa n� aHiv(l,N0LLV3IdIjLHa3 saagmnzd FI/N 'ON alvDiAlim J 'IVDIHMH'IR V/N gVAOUddV H.L7VHH AO JXEMU Vd$a A" O7 XUOA-IMS -buipITnq pTesaaojp aqq go (HENMO) HHgHHHg KIHO'IO oq panssz sz aIP3TITgJa3 aLL �iG/9/Tt aanSSI 96T9-Z O/o NO QEZON SNOIZK'IOIA JNIM4a7ld '2 JI'd.LOHZS SHAONSH O/D SIHS 'JNI'IgaMQ 2 IINVE ENO St panssz sz slgq gotgM xoj Aoupdn000 agy -MPT agq Jo SUOISTAoad aTgeoiTddv aqq go squawaainbaa aqq 90 TTV Oq scuaOJuOo PuP 'pansst Seto 6002 'TZ 711= paqup Z38££ -Z HaEu m A3HVCTfJ00 HO HLFIJIiIISZIHO IqorgA oq quens=nd LS6T '6 'II-dcTv oq ioixd aZinq ONI'I'IEMQ 1t'IIWVa ENO P sod squamazznba2i ajlq oq eCZTEzquEgsgns smzoluoa -off qo'I -ox ds PaZiiT IIozszArpgng Zoo qo'I 2000 43011 6S0 uoigoaS 688£LT, -oil d1M 3mS Aquno, (IH9NVH) (.LHEHSB) ('ON ESnOH) Q'IOHMOS cm SANNE?I 00Z£ Agiadozd go uoigezou ONIrjlHMQ buipi?nq agq gegq SHIdIsHHD SIHS 60/TZ/LO' =agEQ ZVB££ -Z ON AONKdf1J00 30 alvoi3I.LHEo ONIS.SIXE Hud A'N 'PIOT4quOS IIeH uMOZ aogoadsul buipTzng aqq Io aoijjo Mawzxvaaa ONlazing CnOH.LnoS 30 NMO.L f, -ON Kdoa AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS TOWN OF SOUTHOLD WHEN TO USE THIS FORM: This form must be completed by the applicant for any special use permit, site plan approval,use variance,area variance or subdivision approval on property within an agricultural district OR within 500 feet of a farm operation located in an agricultural district. All applications requiring an agricultural data statement must be referred to the Suffolk County Department of Planning in accordance with Section 239m and 239n of the General Municipal Law. 1. Name of Applicant: ���`�` G/-..z-J, 2. Address of Applicant: 6`f Q Q z- 73 z-, 3. Name of Land Owner(if other th Applicant): 4. Address of Land Owner: dr'0or,�ss.� 5. Description of Proposed / Project: 4-dd I. er l.u- — /' /'cyra �,�/ Terme t W/,?w 6. Location of operty: (ro d and Tax map number) ®a /-,f — lea.,, �- 7. Is the parcel withm 500 feet of a farm operation? { } Yes No 8. Is this parcel actively farmed? { }Yes t4 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) Signature of A icant Date Note: 1.The local Board will solicit comments from the owners of land identified above in order to consider the effect of the proposed action on their farm operation. Solicitations will be made by supplying a copy of this statement. 2.Comments returned to the local Board will be taken into consideration as part as the overall review of this application. 3.Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above The cost for mailing shall be paid by the Applicant at the time the application is submitted for review. 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part l -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part l -Project and Spons nformation 1_// Name of Action or Pr ject: ProjectLocation describe,andattacha location map): LJ `� war o dL.a +�"� it Xe�^jk Brief Description otlyroposed Action: dr Name of Applicant or S onsor: Telephone: E-Mail: ec(,,,, .4 . Address: l a a�t� S�avy�✓ ��7�ciy !�o. City/PO: State: Zip Code: T% I c Ic A Z_ 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: 3.a.Total acreage of the site of the proposed action? s S acres b.Total acreage to be physically disturbed? ' rel. &VI aeFFes S c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑ Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial -9-Reidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page l of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? pe- 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ?/ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: v' 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? r/ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: Y/ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? b.Is the proposed action located in an archeological sensitive area? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: -i 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑A*cultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? V1_ 16.Is the project site located in the 100 year flood plain? NO YES IT Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, O' a.Will storm water discharges flow to adjacent properties? ❑NO❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO EYES G✓✓.- fir a�fl .t�C ���. Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: 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 I 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 Applicant/sponsorne: ij r ®v f Date: 7/, 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. 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?" - _ -r- • _ : ;tea., No,or Moderate • .. _ ,y�`y�= .,Zai; =;= small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? !� 6. Will,the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? -7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 1� 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 Board of Zoning Appeals Application AUTHORIZATION (Where the Applicant is not the Owner) I, _/a# CI-Clay 7-c residing at ®4A lj6,Ide,,., � (Print property owner's name) (Mailing Address) do hereby authorize 4f:,"4A e �r (Agent) to apply for variance(s) on my behalf from the Southo Zoning Board of Appeals. gnature) (Print Owner's Name) r APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: ,>%O.y N (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance z/ Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest"means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5% of the shares. YES NO e/ 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 Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee. Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) A)the owner of greater that 5% of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant; or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this d of_Z ,2046 Signature Print Name J o Ham+ t�o 9 7-qt,4.z ej AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same.. YOUR NAME : Z / , J3 /z,,e� (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest"means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5% of the shares. YES NO t-_� 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 Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee. Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this // day of ­20 l�' Signature .�1s't �v Print Name C_ �i ✓���� Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. r 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes",then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. if an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website(southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B.. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# The Application has been submitted to(check appropriate response): Town Board 0 Planning Dept. [—Building Dept. 0 Board of Trustees 1. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital E construction,planning activity,agency regulation, land transaction) Fd (b) Financial assistance(e.g.grant, loan, subsidy) (c) Permit, approval, license,certification: Nature and extent of action; Location of action: "aa i �ywa� 1 - Site acreage:4 lie e-e,4e_ Present land use: Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided:) � A (a) Name of applicant: A s PI L 1---W-4 JML� ir/ yO (b) Mailing address: ®?S® 2�i. (c) Telephone number:Area Code (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 development in the Town of Southold that enhances community character, preserves open space,makes efficient use of infrastructure,makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ❑Yes �No ❑ (Not Applicable- please explain) Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No ❑ (Not Applicable—please explain) 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 E No 0 (Not Applicable—please explain) 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 I:d No (Not Applicable—please explain) 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 0 Yes E No Lrr&Zj (Not Applicable—please explain) 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 F� No[-� (Not Applicable—please explain) Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. See Section III—Policies Pages; 34 through 38 for evaluation criteria. ❑ Yes ❑ No❑ (Not Applicable—please explain) Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No ❑ (Not Applicable—please explain) PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ YeAO No❑ (Not Applicable'—please explain) Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No ❑ (Not Applicable—please explain) 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 Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III —Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No❑ Not Applicable—please explain Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ❑ Not Applicable—please explain Chris Rivera <cdronthebeach@aol.com>cf 29July, 2016 2.30 PM To- Chris Rivera <cdronthebeach@aol.com> 80 dogwood 4 Attachments, 636 KB -S,:rfi�` l y l� e r'Y { J,� .r. � g,s�.� .fid � , -C- �o -•t ,� r, n a� � .} f) c 0-3 I � r„ f� t� �4�� ���;. ,�',�,<;} • ate~ _ �' � � 4 __ :.. 4 v 3-¢ a. y tit %Nz V4 '�' 't` � �i �,g `fid r•� - Rk, r •3� `$�� �"�'r#'� t. '���s,J�.��r; yrs a �a`rs Vis; 3�x s s F n �a� +�,,," �1'.e "� ^be t 1 �pie. '�` �`xr•C p Sr%MgM x ,�iy,°r•� �+ i..: �. �t a # R r��{ a p Christine D. Rivera YTOWN OF SOUTHOLD VIS TY RECORD CAR K OWNER STREET S VILLAGE DISTRICT SUB. LOT FORMER OWNER Cc jjo E _t -ACREAGE ;} _ W TYPE xi OF BUILDING ,f RES.��f j SEAS. VL. FARM Comm. IND. CB. MISC. 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CDN SUFFOLK COUNTY LOT CQVRALE ' o Professional Lan S eyor NEW YORK 1EXI5Tl / PROP ITEM AREA 120 Medford Avenue Patchogue, NY 11772 3 Scale: 1"— 16' D W E�-E`�=fi _(E X 157 1 no�' Phone: 631-475-3192 DECK-5 f PORCH 000S LO Survey Certified To: A pB'iTi0-iS 2881, JOHN COSTANZO To7-A L 16 b, 24,54" JOANNE COSTANZO — � i - o MAY 2'6, 2016 REV. PROP AaJITI'M5 CAt_C' tQT COVERAGE . Dates Surveyed: JUNE 27, 2009 SEPTt—M�8'�' 17,,20- 1 C/ LC &HuW F OA ADD/ COSTANZO