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1000-106.-4-2
OFFICE LOCATION: o���F OlO MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 _ Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Telephone: 631 765-1938 Southold, NY 11971 COU0� 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 June 23, 2016 Re: Coastal Consistency Review for ZBA File Ref RUSSELL H. BATES #6964 SCTM# 1000-106-4-2 RUSSELL H. BATES #6964 - Request for Variances from Article XXIII Section 280-124 and Article III Section 280-15 and the Building Inspector's April 18, 2016 Notice of Disapproval based on an application for building permit to construct an accessory storage shed , at; 1) more than the code permitted maximum lot coverage of 20%, 2) accessory storage shed proposed in other than the code required rear yard, located at: 15 Mill Road, (adj. Mattituck Creek) Mattituck, NY SCTM #1000-106-4-2 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, if is my recommendation that the action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Southold Town Zoning Board of Appeals shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: William Duffy, Town Attorney Office Location:, . ®F $Q(�Pyo { Mailing Address: Town Annex/First Floor,Capital One Bank 53095 Main Road 54375 Main Road(at Youngs Avenue) P.O.Box 1179elm . Southold,NY 11971 G • Southold;NY 11971-0959 http://southoldtown.northfork.net VE BOARD OF APPEALS' v '� TOWN-OF SOUTHOLD APR 27 209� Tel. (631) 765-1809 Fax(631),765-9064 Southold Town April 27, 2016 Planning Board Mark Terry, Principal Planner LVW Coordinator Planning Board Office' , Town,of Southold _ Town Hall Annex 8outhold,�NY 11971 Re: 'ZBA File Ref. No. # 6964 BATES, Russell H. Dear Mark: We have 'received an application to construct an accessory storage,shed. 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. eisman Chairp rson By: G 2 2 SEE SEC NO 099 SEE SEC NO 099 m 14A(c) MATCHLIN s MATCH UNE w N310A82 —_—_-- -z--- _-z- y FOR PCL NOg SEE SEC NO 1 x 099-04 023 4 1A \ n a Q q TOWNHO 92�s.� ( ') 3 Z g .\�� RD. 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NOTICE OF DISAPPROVAL DATE: September 8, 2015 TO: Chris Mauceri (Bates) UPDATED: April 18,2016 4610 Center Boulevard,#1511 Long Island City,NY 11109 Please take notice that your application dated August 25,2015: For permit to construct an accessory storage she Location of property: 15 Mill Road,Mattituck County Tax Map No. 1000—Section 106 Block 4 Lot 2 Is returned herewith and disapproved on the following grounds: The proposed accessory storage shed on this non-conforming 5,600 square foot lot in the Residential R-80 District is not permitted pursuant to Article III Section 280-15 which states-, "In the Agricultural-Conservation District and Low-Density Residential R-80,R-120,R-200 and R-400 Districts accessory buildings and structures or other accessory uses shall be located in the required rear aid_" - - The proposed construction is located in the side yard. In addition the proposed accessory storage shed is not permitted pursuant to Article XXIII Section 280-124 which states non-conforming lots measuring less than 20,000 square feet in total size require a maximum lot coverage of 20%. The survey shows the lot coverage of±28%. Aut ori Signature Note to Applicant: Any change or deviation to the above referenced application,may require further review by the Southold Town Building Department. CC:file, Z.B.A. �rn FORM NO. 3 TOWN OF SOU`I'HOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPI'ROVAC, DATE: September 8, 2015 TO: Chris Mauceri (Bates) UPDATED: April 18, 2016 4610 Center Boulevard,#1511 Long Island City,NY 1 1 109 Please take notice that your application dated August 25,2.015: For permit to construct an accessory storage shed Location of property: 15 Mill Road. Manituck County Tax Map No. 1000—Section 106 Block 4 Lot 2 Is returned herewith and disapproved on the following grounds: The proposed accessory storage shed on this non-conforming 5,600 s uare foot lot in the R_esid_ential R-80 District is not pennitted pursuant to Article XXIII Section 280-11613.which states: "All buildings located ora tots urn which a bulkhead concrete�val1, riprap or similar structure exists and which are adjacent to tidal water bodies other than sounds shal I be set back not less than seventy- five(75) feet from the bulkhead." The construction notes a setback of 11±feet to the existing bulkhead. The proposed accessory storage shed is not permitted I3ur:suant to Article 111, Section 280-15, w ich states: "In the At71ieultui-ai-Conservation Districtand Low-Density Residential R_80, R-120 R-200 and R-400 Districts,accessory buildings and structures or other accessoryuses shalt he_located in the required rear ay r•d - - The proposed construction is located in the side yard. In addition,the proposed accessory storage shed is not permittedpxu-suant to Article XXiil Section 280-124, which states non-conforming lots measuring_1eSs than 2{1,(}00 s uare feet in total size require a maximum lot coverage of 20%. The survey shows the lot coverage of±28%. Auth ,nature Dote to Applicant: Any change or deviation io the above refes-cliced alaplication, may require further review by the Southold Town Building Department. CC.-file, ZRA. FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL DATE: September 8, 2015 TO: Chris Mauceri (Bates) 4610 Center Boulevard, #1511 Long Island City,NY 11109 Please take notice that your application dated August 25, 2015: For permit to construct an accessorLtora storage shed Location of property: 15 Mill Road, Mattituck County Tax Map No. 1000—Section 106 Block 4 Lot 2 Is returned herewith and disapproved on the following grounds: The proposed accessory storage shed on this non-conforming 5,600 square foot lot in the Residential R-80 District is not permitted pursuant to Article XXIII Section 280-116B which states; "All buildings located on lots upon which a bulkhead concrete wall riprap or similar structure exists and which are adjacent to tidal water bodies other than sounds shall be set back not less than sevent- five(75)feet from the bulkhead." The construction notes a setback of l If feet to the existing bulkhead The proposed accessory storage shed is not permitted pursuant to Article III Section 280-15.which states; "In the Agricultural-Conservation District and Low-Density Residential R-80 R-120 R-200 and R-400 Districts, accessory buildings and structures or other accessory uses shall be located in the required rear ard." The proposed construction is located in the side yard In addition,the proposed accessory storage shed is not permitted pursuant to Article XXIII Section 280-124, which states non-conforming lots measuring less than 20,000 square feet in total size require a maximum lot coverage of 20%. The survey shows the lot coverage of±28%. r�f Authorize ture Note to Applicant:Any change or deviation to the,above referenced application,may require further review by the Southold Town Building Department. CC:file, Z.RA. t r� 1 Fee:$ Filed By: Assignment No. APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS �► , AREA VARIANCE House No._ 5" Street q3f d�//tL �� Hamlet 4 / G SCTM 1000 Section 106 Block--Y-Lot(s) Z Lot Size-oX" * Zone I(WE)APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED BASED ON SURVEY/SITE PLAN DATED Owner(s): Mailing Address: [® 6e. 1�� ®�� ��'�/. �� /S &Y Telephone:It7, 6Q. Fax: V4 Email: r(kif. hater eg/% • 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: g.®j M"Ctei' for(Owner( )Other: Address: 6® 'Y?- &f-eAdjge M, X ll# j,j' Telephone 3 f. V9q.5310 Fax: Email: Please check to specify who you wish correspondence to be mailed to,from the above names. (t Applicant/Owner(s), (-'Authorized Representative, ( ) Other Name/Address below: WHEREBY THE BUILDWG INSPECTOR REVIEWED SURVEY/SITE PLAN DATED 1k6 Z? s and DENIED AN APPLICATION DATED -'f :)-FOR: (jouilding 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: Section: Zlao, 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 as, ( ) has not been made at any time with respect to this property, UNDER Appeal No(s). JM L Year(s). 400Q . (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: 0Ta �Pli She °� jle.&A 46k*4Qa^-t -� 61 A fr fMcA 4j e q , y � ®a. me ri, A9- L1014 CgCA 2.The benefit sought by the applicant CANNOT be achieved by some me od feasib a or the applicant to pursue,other than an area variance,because: lsk&vo o. 61k-- kxpaV - 11%, plve-'�7 3.The amount of relief requested is not substantial because: a , AV ��A®P 1 e- �Aisa�a�a� ��aia.r�` 9� �`g��9� 6�4ta 0. 1� VCR 6e l &�� 4- ��� IIS ��� �cna 4.The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: e'p � a� ����� �� 89Q fit ��Je x� � N®L Yos;� e 4 A,,l ®-4. ul�e� c' ��® UJa &f P"fro T _ M;4 CT 5.Has the alleged difficulty been self created? { } Yes,or f4 No Why: Are there any Covenants or Restrictions concerning this land? f#/No { } Yes(please furnish a copy) This is the AIINIMUM 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. P11141< Signature of Applicant or Authoriz gent (Agent must submit written Authorization om Owner Swo o before me this 3t day If vs 20 r 1 9 DENISE A. NAVARRA �� �y���� } NOTARY PUBLIC-STATE OF NEW YORK v/c/ /I No. 01 NA6191295 Notary Public Qualified In Suffolk ounty My Commission Expires ( APPLICANT'S PROJECT DESCRIPTION 4 APPLICANT: i-c% DATE PREPARED: l�6 t 6.- 1.For Demolition of Existing Building Areas Please describe areas being removed: II.New Construction Areas (New Dwelling or New Additions/Extensions): Dimensions of first floor extension: e 1% xaj WX44W& /6"1 r Dimensions of new second floor: Dimensions of floor above second level: Height(from finished ground to top of ridge): 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: -rAe� Number of Floors and Changes WITH Alterations: IV. Calculations of building areas and lot coverage(from surveyor): Existing square footage of buildings on your property: e. l20,0 Proposed increase of building coverage: . �°®� .��e Square footage of your lot: Percentage of coverage of your lot by building area: V.Purpose of New Construction: he .`. ORS 0 4= g4e: ��✓�e�d' �/l�d� d�/��fd ���r����� � 1 .�� Aa�' 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): 14 A r 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 - l QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION A. Is the subject premises listed on the real estate market for sale? Yes _ No B. Are Pere 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? /-0 2.)Are those areas shown on the survey submitted with this application? Ygf 3.)Is the property bulk headed between the wetlands area and the upland building area? 444. +0 xa g 4 , /V F aew.!� 4.)If your property contains wetlands or pond areas,have you contacted Ce 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? Ah E. Are there any patios, concrete barriers,bulkheads or fences that exist that are not shown on the survey that you are submitting? X/9 Please show area of the structures on a diagram if any exist or state none on the above line. P. Do you have any construction taking place at this time concerning your premises? 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? � 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 JVA (ex:existing single family,proposed same with garage,pool or other) Authorize ignature and Date sv4WFOt, > Town of Southold 3/12/2015 53095 Main Rd _ Southold,New York 11971 "•arca" PRE EXISTING CERTIFICATE OF OCCUPANCY No: 37469 Date: 3/12/2015 THIS CERTIFIES that the structure(s)located at: 15 Mill Rd,Mattituck SCTM#: 473889 Sec/Block/Lot: 106.4-2 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 37469 dated 3/12/2015 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame one family dwelling with wood stove and concrete block patio.* NOTE:BP 39326"as built"deck addition and alterations to dwelling COZ-37468 The certificate is issued to Bates,Russell (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 106-4-2 PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Au ed Si ature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 15 Mill Rd,Mattituck SUFF.CO.TAX MAP NO.: 106.4-2 SUBDIVISION: NAME OF OWNER(S): Russell H.Bates OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: Enners,Peter&Enners,Rosemary DATE: 3/12/2015 DWELLING: #STORIES: 1 &2 #EXITS: 3 FOUNDATION: concrete block CELLAR: CRAWL SPACE: 100% BATHROOM(S): 2 TOILET ROOM(S): UTILITY ROOM(S): 1 PORCH TYPE: DECK TYPE: PATIO TYPE: Concrete Block BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: Yes TYPE HEATER: Off Boiler AIR CONDITIONING: TYPE HEAT: Oil WARM AIR: HOT WATER: X #BEDROOMS: 1 #KITCHENS: 1 BASEMENT TYPE: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: GARYF DATE OF INSPECTION: 9/8/2014 TIME START: 09:30 AM END: 10:00 PM TOWN OF SOUTHOLD 25o� '�� BUILDING DEPARTMENT ! TOWN CLERK'S OFFICE p:; SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 39326 Date: 10/29/2014 Permission is hereby granted to: Enners, Peter$Enners, Rosemary 15 East Mill Rd Mattituck, NY 11952 To: "As Built" Deck construction per ZBA#5040, and bathrooms (2) altered, and wood stove installation as applied for At premises located at: 15 Mill Rd, Mattituck SCTM #473889 Sec/Block/Lot# 106.-4-2 Pursuant to application dated 9/11/2014 and approved by the Building Inspector. To expire on 4/29/2016. Fees: AS BUILT-SINGLE FAMILY ADDITION/ALTERATION '$560.00 CO-ADDITION TO DWELLING $50.00 Total: $610.00 Building Inspector �;t%' Fpt,� Town of Southold 3/12/2015 Q2�ry� P.O.Box 1179 53095 Main Rd • c� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 37468 Date: 3/11/2015 THIS CERTIFIES that the building AS BUILT DECK Location of Property: 15 Mill Rd,Mattituck, SCTM#: 473889 Sec/Block/Lot: 106.4-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9/11/2014 pursuant to which Building Permit No. 39326 dated 10/29/2014 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: "as built"deck addition, and alterations, including 2 bathrooms and wood stove in an existing one family dwelling as applied for per ZBA#5040,dated 1/10/2002. The certificate is issued to Russell H.Bates (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 39326 9/11/2014 PLUMBERS CERTIFICATION DATED 9/10/2014 Bryan Phillips Plumbing t riz Si ture APPEALS BOARD MEMBERS ufrFO� Southold Town Hall Gerard P. Goehringer, Chairman ��O ��✓y 53095 Main Road . James Dinizio,Jr. P.O.Box 1179 Lydia A.Tortora Southold,New York 11971-0959 Lora S. Collins ;5S- �� ZBA Fax(631)765-9064 George Horning ,- �a� -Telephone(631)765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS,DELIBERATIONS AND DETERMINATION MEETING OF JANUARY 10,2002 Appl.No.5040—PETER AND ROSEMARY ENNERS 1000-106-4-2 STREET.&LOCATION: 15 East Mill Road,Matfituck DATE OF PUBLIC HEARING: January 10,2002 j FINDINGS OF FACT f PROPERTY FACTS/DESCRIPTION: Applicants' property. is-located at the end of Mill Road in Mattituck with water fronting on three sides of the property. The lot is 5,600 sq. ft. in area and is improved with a single-family dwelling as shown on the survey prepared by Peconic Surveyors dated j October 11, 2001. The dwelling as exists is shown at 16' between the northeast corner of the house and the northerly bulkhead at its closest point. BASIS OF APPLICATION: The basis of this-application is the Building Department's October 18, 2001 Notice of Disapproval which states that the open deck construction must conform to the requirements of Section 100-244B and Section 100-239.4B regarding the Code's limited setback required, from the bulkhead, and lot coverage limitation not to exceed twenty (20) percent of the total lot area. AREA 'VARIANCE RELIEF REQUESTED: Applicant is requesting a setback of 13 feet from the bulkhead at its closest point and a lot coverage of 21 percent, for a proposed open deck(5' x 20'), The location of the deck is at the northenvesterly corner of-the dwelling, landward of the dwelling's westerly side. All sides of the dwelling are less than 75 feet fi-om the bulkhead or property line. REASONS FOR BOARD ACTION: Based on the testimony and record before the Board and personal inspection,the Board makes the following findings: 1. Grant of an area variance will not produce an undesirable change in the character of the neighborhood, or be a detriment to nearby properties because the addition of the open deck toward the northerly property line is necessary as an access into the dwelling. 2. The benefit sought by the applicant cannot he achieved by some method, feasible for the applicant to pursue, other than an area variance. The lot is extremely small in size and the dwelling encompasses a major portion of the upland area of the lot. 3. The proposed variance will not have an adverse effect or impact on the physical or environmental conditions in the neighborhood. The deck is proposed as an open, unroofed deck, within the confines of the upland area of the lot. A stone wall, rip rap, surrounds the upland area. 4. The variance is not self created. The lot is unique in its size,layout and location. 5. In considering this application,the Board deems this action to be the minimum necessary and Page 2—January 10, 2002 ZBA Appl. No. 5040.—P. and R. Enners Parcel 1000-106-4-2 at Mattituck adequate to enable the applicants to enjoy the benefit of a new location for a dwelling,while preserving and protecting the character'of the neighborhood and the health,safety,welfare of the community. RESOLUTIONIACTION OF THE BOARD: In considering all of the above factors, and applying the balancing test under New York Town Law, motion was offered by Chairman Goehringer, seconded by Member Collins,and duly carried,to GRANT the variance as-applied for and SUBJECT TO CONDITION that the deck remain unroofed and open to the sky. This action does not authorize or condone any current or future use, setback or other feature of the subject property that violates the Zoning Code, other- than such uses, setbacks and other features as are expressly addressed in this action. Vote of the Board: Ayes: Members Goebringer (Chairman), Tortora, Collins, and Horning. This Resolution was duly adopted(4-0). (Member Dinizio was ab erar P. Goehringer,Chm' an CLE-P.y UR t �GRICLZ:T-RAL DA3'�ST�TF3LE -T ZONING BOARD OF APPEAL-S �{ TOWN OF SOUTHOLD WHEN TO USE THIS FORM: This form must be completed by the applicant for any special use permit, r site Ian approval,use variance area variance or subdivision approval on roPe�1within an agricultural district OR within 500 feet of a fare:operation located in an agricultural district. All applications requiring an agricultural data statement must be referred to the Suffolk Connty Department of Plannntg in accordance with Section 23399m and 239n of the General Municipal Law. 1. Name of Applicant: 7 5 1`1`guaq, 2. Address of Applicant: 123o 7-2-thOGo 3. Name of Land Owner(if other than Applicant): Pt.;,%k5b'r 4. Address ofLand Owner. /'5— 46-3— 1n4z— 5. Description of Proposed Project: / Y :r, .Sly 6. Location of Property:(road and Tax map number) /,-- 7. f7. Is the parcel within 500 feet of a farm operation?{ } Yes (P No 8. Is this parcel actively farmed? { }Yes 0 N 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 th p ge i re are dditional property owners) Signature of Applicant Date Note: 1.The local Board will solicit comments from the owners of land identified above in order to consider the effect of the proposed action on their farm operation. Solicitations will be made by supplying a copy of this statement. 2.Comments returned to the local Board will be taken into consideration as part as the overall review of this application. 3.Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above. The cost for mailing shall be paid by the Applicant at the time the application is submitted for review. 17 617.20 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 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1 -Project and Sponsor Information Name of Action or Project: 60LPt,f pm Project Location(describe,and attach a location map): Brief Description of Proposed Action: PI&CZA a�(a(46,,, Je home, WS1 CeAA,- #40-7'9k 40#Wt ®fir s � ave,.l'1611. Q. f� ) . Name of Applicant or Sponsor: Telephone: I3 01 ki E-Mail:n�f. Address: City/PO: State: Zip Code: �f Qac 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? acres 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 sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑ Rural(non-agriculture) ❑Industrial aEommercial @<Qdential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page I 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? 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: �e �S S o It-,J 1 t :H:% X 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? 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: V 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: MA V 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: Npr a f�zj 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:g tnA "If 6L 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional PrVetland ❑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? 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, � a.Will storm water discharges flow to adjacent properties? ®'NO❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: Cl'f,10❑YES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO I 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 J YES solid waste management facility? If Yes,describe: I/ 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 �j� Applicant/sponsor name: ''"` 9�l� ��. �� j Date: 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?" No,or Moderate l small to large -- - — impact impact = may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, €� architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 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, ��P�1 g� l `-� • 11-kS residing at LK 90 Com,kr 1A -jJ i`,y 6 g (Print property owner's name) (Mailing Address) LOAA 1,61aj Ct d H 6 do hereby authorize °s 4�.a (Agent) to apply for variance(s) on my behalf from the Southold Zoning Board of Appeals. ldkkl�r ( wner's Signature) 48(til NAAr (Print Owner's Name) 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: vCt e (�_4)fj 5 (Last name,first name,middle i itial,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 If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee. Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this of 20 Signature Print Name APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. ,���//� YOUR NAME : b�dL1 # (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 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 gouthold 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 3 day of AL 20 Signature All Print Name 2 # e, Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question-in Section C on this form is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# - - The Application has been submitted to(check appropriate response): Town Board 0 Planning Dept. 0 Building Dept. Board of Trustees 0 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g.capital 0 constriction, planning activity,agency regulation, land transaction) (b) Financial assistance(e.g.grant, loan, subsidy) (c) Permit,approval, license,certification: Nature and extent of action: � a.2 n.L A Lai 4 s. fRt�a®9 np$ :, &.V*%6 t Location of action: i ea Site acreage: 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) Name of applicant: (b) Mailing address: 1 dR� — (c) Telephone number:Area Code( ) fl'7 . 9 . 1® 1 (d) Application number, if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No 1�r 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) e. ke B .. ILrs '-we-5,21 ♦ .fb N[s `,� �i(�i P� Attach additional sheets if necessary V / 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) IA - 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 [j] (Not Applicable—please explain) X44 o,n �d�d��^ eaa�26 ��' �il/.S/a �a9�� `�Ra�a.a. So 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 E No 0 (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 Yes E No u (Not Applicable—please explain) 4� A,— � 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 [:d No® (Not Applicable—please explain) #Q � She- 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 1-1No � (Not Applicable—please explain) A/ 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. ❑ Ye❑ No (Not Applicable—please explain) A14 - J-Aed L PtolI &J�,1 ya v.%d / XAS� be#!7 �-4 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) Pf A- o A 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 N* - rA c 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 F] No�1 Not Applicable—please explain a 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 I� Not Applicable—please explain a •a 1' ;s ,` , { � r t I r s J • b. ~ 00 -..A M�m. .1 4-47 1-y x �.•', �w jk 46, fo s. �: doe" ;* t TOWN OF SOUTHOLD OPERTY RECORD CARD OWNER STREET VILLAGE DISTRICT SUB. LO FORMER- WNER N E ACREAGE Qop Y-,2 P- 41* rv.rs W „j s TYPE OF BU' ILDING Jr RES. r SEAS. VL. FARM comm. I IND. I CB. MISC. LAND W IMP. TOTAL DATE REMARKS 0 D Zr Z' DwY 10 L,, jif /0 0 o ,Z;zg /9&0 700 qjiqi,-t—Liz-7qop (D4b -eviy1ofs559- S, - jff, 0 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE !2 0 Form Acre Value Per Acre Value Tillable I Tillable 2 Tillable, 3 Wcodland Swampland Brushland House Plot Total f' 4 c s . ■■■■■■■■■■■■■■■■■■■■ PrP ■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■gi■!-■■ ■■■■ MIMEMENKNEy. .�t'�u�q�ye~ 3f i� ��{r L 3 ;`i �t'S7` et 'F K Kn.? �' ■■■■���■■����'ffiamm ENO MENEM ■■■■■■ +.`'...... ar'•`,.r.:: �-:fir- :h.• , ::, in.s i.. p..,. ti...,. OMEN Room I r J , ..1.. .:.1 ., . :. �'�N MIEEE ■■EEN■iE�■EEEN■EMI r, ,j Fit. J.t`, sy�^ Xar45i "ir *. 'L��f2:. , r Zb,1.' tNS. "r's is ` c ■■■■■■E■�I-R�� ■■■■■■■ ■■EE■E■EE■■E.V EE■■EE■ ■■■■■■■■■■■■ ■MINE■■■ Basement • � Ext. Walls Interior Fire Place Rooms Ist Floor Driveway Rooms 2nd Floor i i I 161-011 JIM DEERKOSKI, PE phone: (631) 298-7116 2%" 7 3/411 � L O u, 141-511 1 Ln 71 m Q N 1 1 1 1 1 1 L , 1 1 1 1 1 1 1 �j 1 I I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 W 2X6 RR @16"OC i 6X6 ACQ �o POST O ' Ln 1 Ln 6X6 ACID, PERIMETER GRAVEL- -BASE _Q •o •p 8"CONC. CL C& GEOGRAPHIC DESIGN CRITERIA f�1 p p PIER FROST WINTER ICESHIELD • • SNOWO SPEED WEATHERIN LINE TERMITE DECAY DESIGN UNDERLAYME FLOOD LOAD (MPH) C f DEPTH TEMP. REQUIRED HAZARDS SEVERE 3 FT. MODERATE SLIGHT TO 11 NONE - 28 LBS. 120 TO HEAVYMODERATE DRAWN BY• J D CONSTRUCTION FLAN NAILING SCHEDULE NAIL SCALE: 1/411 = II-0II { JOINT DESCRIPTION 0TY. SPACING NOTES 10/��2�1� JOIST TO PER TOE �F NEW .,TOP PLATE OR GIRDE 4-8d COMMON JOIST NAIL D F�NEW), 10/3/2015 2-BdCOMMON ,(1 BRIDGING EACH TOE �P �• /? TO JOIST END NAIL GJtiv .'?b� O BLOCKING EACH TOE S �7 2-8d COMMON Q- k.a r fl:. SCALE: SEE PLA TO JOIST END NAIL _ -- tiCj BLOCKING TO EACH TOE 3-16d COMMO -, ��•`=at. LU SILL OR TOP PLATE BLOCK NAIL LEDGER STRIP EACH FACE (n a_ '1.i,7�• 3-16d COMMO ti, r TO BEAM JOIST NAIL JOIST ON LEDGER PER TOE '7 �� SHEET N O a TO BEAM 3-8d COMMON JOIST NAIL �Q O. !� BAND JOIST PER END \AjQO C �:� TO JOIST 3-16d COMMO JOIST NAIL Fp4zs1 BAND JOIST TO 2-16d COMMO PER TOE NAIL SILL OR TOP PLATE FOOT ROOF AREA-60 SQ Fl- @100% T@100% RUNOFF-10 CU.FT ;4 WATER RUNOFF INTO GRAVEL f REVISIONS: SITE DATA: SCTM # 1000-106-04-02 DESCRIPTION: SQ. FT. AREA: LOT COVERAGE: EXCAVATE: FILL: 0 PROPERTY: 5,600 SQ,FT. 0 0 0 0 EXISTING HOUSE: 1083 SF 19.3% M. ALONG BULKHEAD EXISTING DECKS: 429 SF 7.7% BULK - --_ N 70038'35" E 54.98' PROPOSED SHED: 75 SF 1.3% 1 YD. .5 YD '',WOOD 111 !�PLAT. n+ rn V. U �. TOTAL: 1587 SF 28.3% 1 YD. 5 YDcd N r DECK 37.1' rn 116 MEETS & BOUNDS 5 o m EX' &2 Ste' BY: PECONIC SURVEYORS ° M A T T I T U C K n FRAMED HOUSE 5x16 ; ��t�os � DATED: AUGUST 29.2001 SHED z 0 S CREEK c m 21.0' w A ell N � A IV w TIE LINE _ O �. X43.1' M.H.W.M. Q., QI ry h� L F 8.072' UTILITY S 689623"W ' POLE i IO �O Im GRAVEL OVER ASPHALT C� sT o . � im ��o C CONCRETE WALL C ��Q�; w X31 Ro 20.00' SITE PLAN O x,43,19' W SCALE: 1" = 20'-0' DRAWN. MH/MS SCALE- 1/4"=1'-0" ]OB#: December 10,2015 SHEET NUMBER* S-1