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HomeMy WebLinkAbout#8110-1875 Jackson LLC ZBA Application ( I FORM NO. 3 1 4 TOWN OF SOUTHOLD Received BUILDING DEPARTMENT SOUTHOLD,N.Y. MAR 0.4 2026 NOTICE OF DISAPPROVAL Zoning Board of Appeals Date: February 12, 2026 TO: 1875 Jackson LLC PO BOX 66 150 King St PO BOX 66 New Suffolk,NY, 11956 Please take notice that your application received February 11, 2026: For permit to: construct a raised patio addition to a sing-1 -famil wellin at: Location of property: 1875 Jackson Street blew Suffolk NY County Tax Map No. 1000—Section 117 Block 9 Lot 14 Is returned herewith and disapproved on the following grounds: The raised patio construction on this non---- - nro:in 10 890 s . ft, parcel in the Residential R-40 District is not permitted 2mrsuant Article XXIII 280-124 which states lots measuring,less than 20,000 square feet in total size require a minimurn front and setback of 35 feet. The proposed construction, as shown on the survey. has a front vard setback of 21.3 feet, *NOD is in conjunction with BP 50030 A razed 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. APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS AREA VARIANCE House No. 1875 Street;Jackson St Hamlet New fell SCTM 1000 Section: 117 Block: 9 Lot(s) 14 Lot Size: 16 5 722 S 1= 6 I(WE)APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPVCT afgRol Appeals DATED 02,.12 BASED ONSU,I ISITE PLAN DATED �. Owner(s): David Noonan Mailing Address: p Tele hone• Fax: Email:, 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: Zacke E. Nicholson BA forXOwner( )Other: Address: PO Box 88 - CutphO u@ NY 11935 Telephone: 631.513.6589 Fax: _Email: ZENicholson.Archagmail.com Please check to specify who you wish correspondence to be mailed to,from the above names: Applicant/Owner(s), N Authorized Representative, ( )Other Name/Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED /SITE PLAN DATED 12.23.25 and DENIED° -A. LIC FOR: ww.. ................... ( )Building Permit WORK DONE ( )Certificate of Occupancy ( )Pre-Certificate of Occupancy UNDER ORIGINAL ( )Change of Use BUILDING PERMIT Permit for As-Built Construction No.50030 DATED 10/30/23 ( )Other: ..... ..-- Provision of the Zoning Ordinance Appealed. (Indicate Article,Section,Subsection of Zoning Ordinance by numbers.Do not quote the code.) Article: XXIII Section:280-1.24 Subsection: Type of Appeal. An Appeal is made for: >(A Variance to the Zoning Code or Zoning Map. ( )A Variance due to lacy of access required by New York Town Law-Section 280-A. ( )Interpretation of the Town Code,Article Section ( )Request for Reversal or Overturn the Zoning Officer's Denial Other A prior appeal( )has, Was not been made at anj time with res ect to this propetty, UNDER Appeal No(s). Yar(s). . (Please be sure to research before completing this question or call our office for assistance) Page 2,Area Variance Application Revised 6/2023 REASONS FOR APPEAL Receive (Please be specific,additional sheets may be used►Pith preparer's signature notarized) 6 2026 MAR o, 1.An undesirable change will;not be produced in the CHARACTER of the neighbor or a detriment to nearby properties if granted,because: Board of Appeals An undesirable change will not be produced in the character of the neighborhood because the patio is c9Q[M1d in materials consistent with the surrounding residences and remains largely at grade.The slightly elevated portion is minimal in height and is visually softened by new plantings and landscape improvements.From the street and adjacent properties, the patio is largely screened and does not introduce massing,height,or built form inconsistent with the neighborhood. 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: Due to the existing grade conditions of the site,constructing the patio entirely at grade would have required substantial import of fill and regrading of the side yard area.This would have significantly altered existing drainage patterns and landscaping and introduced unnecessary site disturbance.In light of these conditions,strict compliance would have resulted in greater environmental impact than the minor dimensional deviation now requested. 3.The amount of relief requested is not substantial because: While the patio was constructed as part of the overall site improvements,the need for this variance arose from existing site grade constraints and the effort to minimize excessive import of fill.To the extent the condition may be considered self-created, it was not the result of an intent to circumvent zoning requirements but rather an effort to balance grading,drainage,and landscape design considerations.In any event,a self-created hardship is but one factor for the Board's consideration and does not outweigh the minimal nature of the requested relief and the absence of adverse impact. 4.The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: The patio will not have an adverse effect on physical or environmental conditions in the neighborhood.The surface area is limited,runoff is managed within the site,and the surrounding yard areas have been properly graded to direct stormwater away from adjacent properties.The installation does not increase building mass or density and does not create impacts to neighboring views,light,or air. 5.Has the alleged difficulty been self created? { } Yes,or XA No Why: The patio is modest in size and functions as accessory hardscape serving the residence.The encroachment into the required front yard setback is limited and does not involve enclosed space,vertical construction,or an increase in building area.The applicant made a good faith effort to keep the patio as low as practicable in order to minimize the need for fill and reduce its visual presence. • Are there any Covenants or Restrictions concerning this land? M 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. By signing this document,the PROPERTY OWNER understands that pursuant to Chapter 280- 146(B)of the Code of the Town of Southold,any variance granted by the Board of Appeals shall become null and void where a Certificate of Occupancy has not been procured,and/or a subdivision map has not been filed with the Suffolk County Clerk,within three(3)years from the date such variance was granted. The Board may,upon written request prior to the date of expiration,grant an extension not to exceed three(3)consecutive one(1)year terms. IT IS THE PROPERTY OWNER'S RESPONSIBILITY TO ENSURE COMPLIANCE WITH THE CODE REQUIRED TIME FRAME DESCRIBED HEREIN. Signature of ApplicantX.Autlioried Agent (Agent must submit written Authorization from Owner) Sworn to before me this —3 05 day .J Kim E.Fuentes of �u ,20,' Notary Public,State of New York Qualified in Suffolk County ulalic UC.#01 FU4811709 Notary l �4. Commisslon fires ril 10, Zoning Board of Appeals 11y APPLICANT'S PROJECT DESCRIPTION APPLICANT: 1875 JACKSON LLC SCTM No. 1000-117-99q ceiveci- 1.For Demolition of Existing Building Areas LIAR 0,6 2026 Please describe areas being removed: card of Appe8lt' NA U.New Construction Areas(New Dwelling or New Additions/Extensions): Dimensions of first floor extension: N/A Dimensions of new second floor: Dimensions of floor above second level: Height(from existing natural grade): 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: N/A Number of Floors and Changes WITH Alterations: IV. Calculations of building areas and lot coverage,sky plane(From Surveyor,Design Professional): Existing square footage of buildings on your property: 2 760 SF Main blouse 627 SF Gara e Proposed increase of building coverage: AS _ Square footage of your lot: 16 722 SF Percentage of coverage of your lot by building area(lot coverage) 110 BUildin % P 01 + 20 Mats Patio Gross Floor Area(GFA)of single family dwelling including the attached garage and/or habitable detached accessory structure: (Please refer to Chapter 280, Section 280-207 of the Town Code): 2 760 SF M in House a& +-300 SF Finished Garage For Residential lots,is project within the allowable S1W Plane? (Please refer to Chapter 280, Section 280-208 of the Town Code): N/A V.Purpose of New Construction: Jhq..Wrposgh i 1 PMAdO aCCOSSOrYl r 01119 space servin the residence. Due to existing site slope conditions a pprtion of the patio was modestly elevated in order to achieve a functional, level surface while minimizing excessive regrading and import of fill. 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): Describe on separate page if needed: Mostly flat. Modest pitch from West down to East side of ro e 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. Revised 6/2023 QUESTIONNAIRE �� FOR FILING WITH YOUR ZBA APP.LICATI A. Is the subject premises currently listed on the real estate market for saR 0 206 Yes __X_No Zoning Board. )f Appeais B. Are there any proposals to change or alter land contours? No Yes,please explain on separate sheet. C. 1.)Are there areas that contain sand or wetland grasses?_No 2.)Are those areas shown on the survey submitted with this application? N/A 3.)Is the property bulk headed between the wetlands area and the upland building area? N/A 4.)If your property contains wetlands or pond areas,have you contacted the Office of the BOARD Of TRUSTEES for its determination of jurisdiction? N/A Please confirm status of your inquiry or application with the Board of Trustees: If issued,please attach copies of your permit listing conditions of approval with a copy of the 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? NO E. Are there any patios,concrete barriers,bulkheads or fences that exist that are not shown on the survey that you are submitting? All are shown on Site Plat If any of the aforementioned items exist on your property,please show them on a site plan. F. Are there any construction projects currently in process on your property? If yes,please submit a copy of your building permit and survey as approved by the Building Department and please describe scope of work: No - work is complete - workinq toward CO G. Please attach all pre-certificates of occupancy and certificates of occupancy for the subject premises. If none exist,please apply to the Building Department to 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? Yes If yes,please label the proximity of your lands on your survey and identify the Suffolk County Tax Map No. 1000-117-8-4 I. Please list present use or operations conducted at your property,and/or the proposed use ,proposed:same with garage,pool or other) J. (examples:existing single t"arni y 02.13.26 Authorize 'gnatur Date BOARD MEMBERS rjf so Southold Town Hall Leslie Kanes Weisman,Chairperson ,�� 53095 Main Road•P.O.Box 1179 ' Southold,NY 11971-0959 Patricia Acampora : O Eric Dantes Torun nd x"irstoor; Robert Lehnert,Jr. " � 54375 Main Roa Yaenue) Nicholas Planamento Ir Southol ,, l u1[L�U Zoning Board. of Appoals http://southoldtownny.gov ZONING BOARD OF APPEALS01 TOWN OF SOUTHOLD Tel.(631)765-1809•Fax(631)765-9064 STATUS OF FILE ZBA# ®t q Name : l 8 I S \I��(%� LL C �U� (� Tax Map# t� 'r 1 � —�� Location: 6 7 J—Gt�m 51� [ ] Refund issued CANNOT activate or reactivate file (Applicant has withdrawn application). [ ] NO REFUND DUE, based on time spent for Town to process application and hearings. Obsolete & expired; CANNOT reactivate this file:NEW APPLICATION NECESSARY: extensive time has passed; Zoning Code changes are now in effect and this application expired NOTE: Applicant may apply for a new application with Building Inspector for a new Notice of Disapproval and submit NEW application with all documents and current maps to ZBA, or modify plan to conform to the current code. This Town file based on applicant's previous year requests has expired. [ ] No forms to be scanned; FILE# VOID: APPLICATION RETURNED.- (All forms were, returned to applicant early in process,as requested by applicant.) FYI: Please note: Unless otherwise agreed by Resolution of the Board of Appeals, a submission for processing that is incomplete or outdated,with or without activity or updates by the applicant for 12 months or more,remain INCOMPLETE and may not be further processed. Also, an application remains incomplete when it is NOT up-to-date under the current year Zoning Code, LWRP,FEMA or other Codes,or not followed up by applicant with the Building Inspector under current Codes. If applicant wishes to begin a complete application for processing,an applicant is requested follow steps under the current code for a new application submission as per agency's current Instruction Sheet. In all situations, an Applicant ALWAYS has the option to EITHER: (a), follow the Town's procedure for a Notice of Disapproval and apply for a variance with a new submissions and current code filing fees under the current Codes, or (b) if applicant's chooses to modify plan to conform to the current Zoning Code,applicant will not need to return to ZBA with a new application. ZEN DESIGN RECEI caws ZACKERY E. NICHOLSON POST OFFICE BOX 88 JUL 10 21V#R Q 6 2026 CUTCHOGUE, NY 11935 ZENI CHOLSON.ARCH@GMAIL.COM 631.513.6589 ZONING 190AIEVABoard Qf Appeals FALS Southold Town Zoning Board of Appeals July 10, 2025 Southold Town Hall 53095 Main Road P.O. Box1179 Southold, NY 11971 Dear Members of the Zoning Board, I am writing on behalf of my client, 1875 Jackson LLC, regarding the pending variance application for a proposed dormer addition at 1875 Jackson Street, New Suffolk. Please be advised that the applicant has decided t a the application at this time. This decision was made at the discretion of the fir Jperty owner, and we respectfully ask that the application be removed from the ZBA agenda and any further consideration. Thank you for your time and attention to this matter. Please confirm receipt of this withdrawal at your earliest convenience. Sincerely, Zackery E. Nicholson, RA TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE „ 0 SOUTHOLD, NY Received, Q� BUILDING PERMIT MAR 0 6 2026 (THIS PERMIT MUST BE KEPT ON THE PREMISZESng Board of Aweai`' WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 51046 Date: 8/8/2024 Permission is hereby granted to: 1875 Jackson LLC 150 Kin St PO Box 66 New Suffolk, NY 11956 To: Construct alterations to an existing non-habitable accessory garage as applied for. At premises located at: 1875 Jackson St., New Suffolk SCTM #473889 Sec/Block/Lot# 117.-9-14 - Pursuant to application dated 8/612024 and approved by the Building Inspector. To expire on 2/7/2026. Fees: ACCESSORY $125.00 CO-ACCESSORY BUILDING $100.00 Total: $225.00 Building Inspector _. TOWN OF SOUTHOLD r* �r 'r " BUILDING DEPARTMENT TOWN CLERK'S OFFICE Rp SOUTHOLD, NY BUILDING PERMIT MAR 0 12026 (THIS PERMIT MUST BE KEPT ON THE PREMISE oning Board ,of Appeals WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 50533 Date: 4/10/2024 Permission is hereby granted to: Gill Michael PO BOX 507 Cutcho ue NY 119�35 To: construct accessory in-ground swimming pool as applied for. At premises located at: 1875 Jackson St New Suffolk SCTM #473889 Sec/Block/Lot# 117.-9-14 Pursuant to application dated 2/14/2024 and approved by the Building Inspector. To expire on 10/10/2025. Fees: SWIMMING POOLS-IN-GROUND WITH FENCE ENCLOSURE $300.00 CO-SWIMMING POOL $100.00 Total: $400.00 Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT 11 Office of the Building Inspector eceive 1 rr Town Hall Southold, N.Y. LIAR Q,6 2026 CERTIFICATE OF OCCUPANCY Zoning Board of Appeals No Z-22013 Date DECEMBER 8 1992 THIS CERTIFIES that the building ADDITION Location of Property 1HouseANo.ON STET Street SUFFOLK N.Y.Hamlet County Tax Map No. 1000 Section 117 Block 9 dot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 16, 1990 pursuant -to which Building Permit No. 1921 -E dated JULY 20 1990 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to MICHAEL E. GUILL & BARBARA BUTTE'RWORTH (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A. UNDERWRITERS CERTIFICATE NO. N A PLUMBERS CERTIFICATION DATED NIA Building Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Received I Town Hall Southold, N.Y. MAR Q 6 2026 CERTIFICATE OF OCCUPANCY Zoning Board of Appeals. No Z-22352 Date MAY 21, 1993 THIS CERTIFIES that the building ALTERATION Location of Property 1875 JACKSON ST.&615 FOURTH ST., NEW SU'"'OLX N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 11.7 Bloch 9 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DULY 12_, 1991 pursuant to which g JULY 19 1991 Building Permit Na. 20031-Z date 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 ALTERATIONS TO EXISTING ACCESSORY GARAGE AS APPLIED FOR The certificate is issued to MICHAEL GILL & ANO. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE NO. N-275992 - MAY 141 1993 PLUMBERS CERTIFICATION DATED N/A '4' 1 r /euiYding-fnspector Rev. 1/81 r " FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT R eC N yW Office of the Building Inspector Town Hall Southold, N.Y. MAR Q 6 2026 PRE EXISTING Zoning Board ofi ,appeals CERTIFICATE OF OCCUPANCY No Z-18803 Date FEBRUARY 15 1990 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 615 FOURTH ST. & 1875 JACKSON ST. NEW SUFFOLK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 9 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the requirements for a private one family dwelling built prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCC. #Z-18803 dated FEBRUARY 15 1990 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 ONE FAMILY DWELLING WITH WOOD FRAME ACCESSORY GARAGE WITH WOOD FRAME STORAGE SHED ATTACHED TO GARAGE - * The certificate is issued to ESTATE OF MALVIENNE STARBUCK ACKER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NO RECORD PRE EXISTING UNDERWRITERS CERTIFICATE NO. NO RECORD PRE EXISTING PLUMBERS CERTIFICATION DATEDNO RECORD PRE EXISTING *SEE ATTACHED INSPECTION REPORT. Building Inspector BUILDIING DEPARTNEDIT T0,'J-N OF SOUTHOLD, N. Y. HOUSI'dG CODE INSPECTION REPORT YDW3 MAR 0 6 2026 Location 615 FOURTH ST. d 1875 JACKSON STREET NEW SUFFOLK, N.Y. lnumoer & street) G, "* 1 0 'WAppeals Subdivision Pla,v No. Lot(s Name of Owner(s) ESTATE OF MALVIENNE STARBDCK ACKER Occupancy R-40 OWNER (type) owner-tenant Admitted by: MR- KING Accompanied by: SAME Key available Suffolk Co. Tax No. 117-9-14 Source of request THOMAS M. METTLER, EXECUTOR Date 12/29/89 D�•lELLIPiG M Type of construction WOOD FRAME stories 2 Foundation CEMENT BLOCK Cellar 1/2 Crawl space I/2 Total rooms, 1st. Fl 4 2nd. Fl 3 3rd. Fl Bathroom(s) ONE Toilet room(s)_ ONE Porch, type Deck, type Patio, type_ Breezeiay Garage Utility room Type Heat LILCO GAS Warm Air Hot-water XX Fireplace(s) ONE No. Exits 2 Airconditioning Domestic hot-water LILCO GAS Type heater RHEAM Other ACCESSORY STRUCTURES: WOOD FRAME ATTACHED Garage, type const.WOOD FRAMs Storage, type constTO GARAGE. Swimming pool Guest, type const. Other VIOLATIONS: CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE Location Descrintion Art. M Sec. Remarks: Inspected by:AGAR7YJ;FFISH_ Date of Insp. FEB. 14. 1990 . Time start 1 1:00 end 11:20 1 �r IOWN OF SOUTHOLD � BUILDING DEPARTMENT � �C TOWN CLERK'S OFFICE SOUTHOLD, NY Received BUILDING PERMIT MAR 0 6 2026 (THIS PERMIT MUST BE KEPT ON THE PREMISBSning Board of Appeals WITH ONE SET OF APPROVED PLANS AND SPECIFIC TIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 50030 Date: 11/16/2023 Permission is hereby granted to: Gill Michael PO BOX 507 Cute jue NY 11935 To: Demolish portions of and additions to an existing two story single-family dwelling as applied for. Additional approvals, certification or amendment may be required. At premises located at: 1875 Jackson S New Suffolk SCTM #473889 Sec/Block/Lot# 117.-9-14 Pursuant to application dated 10/30/2023 and approved by the Building Inspector. To expire on 511612025. Fees: DEMOLITION $548.40 Total: $548.40 Building Inspector k TOWN OF SOUTHOLD—BUILDING DEPARTMENT Aved Town Hall Annex 54375 Main Road P.O, Box 1179 Southold,NY 11971- " Telephone(631)765-1802 Fax(631) 765-9502 Mattos://www.s g4bgIdtownpl,IVIIAR ®S 2026 A 8rd bf Appeals APPLICATION FOR BUILDING PERMIT For Office Use Only W-- h I '0 PERMIT NO. Building Insprr OCT 3 Q 2023 Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant Is not the owner,an Building Department Owners Authorization form(Page 2)shall be completed. Town of Southold Date: r - 71-) - 207113 OWNER(S)OF PROPERTY: Name: UG sCTM#1000- 14 Project Address: r 561 S� ':::?0'(,MCG cA at VJ q S� Phone#: Email: Mailing Address: CONTACT PERSON: Name: Mailing Address: Phone#: Email. DESIGN PROFESSIONAL INFORMATION: Name: �I C'uUA g Mailing Address: 'PC) � CJ' CD U, V-'- -i il �y Vex" Phone#: I�0— �, Email: . 5 I CONTRACTOR INFORMATION: Name: T ° r,ho Mailing Address: �! yj S r Phone#: I--qt�93 —(� �(j Email: ---aybqS htx DESCRIPTION OF PROPOSED CONSTRUCTION ❑New St acre CAddition tioro paiArnollition Estimated Cost of Project: Other *t� $ Will the lot be re-graded? ❑Yes O(No Will excess fill be removed from premises? ❑Yes Wo 1 PROPERTY INFORMATION Existing use of property: Intended use of ro erty: P P Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to O +y this property? ❑Yes)(No IF YES,PROVIDE A COPY. 19 Check Box After Reading: The owner/wntrador/deop professlonal is responsible for aN drainage and storm water issues as provided by Chapter 236 of the Town Code.APPUCATION IS HEREBY MADE to the BuNding Department for the issuance of a Building Permit pursuant to the Building zone ordinance of the Town of Southold,Suffolk,county,New York and other applicable Laws,ordinances or Rgpdadoms,for the construction of buildings, additions,alterations or for removal or demolition as herein desalbad.The applicant apses to comply with all appikable laws,ordnarmes,building code, housing code and regulations and to admit authorized Inspectors an premises and In bulldln&)for necessary hrspectlom.False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210AS of the New York State Penal Law. rl MAR 06 2 Application Submitted B pl i t dame): []Authorized Agent DJ6Ler :Signature of Applicant _ Date: Zor oq 2!°A712 3PPeals STATE OF NEW YORK) COUNTY OF IV 0..\f" �, L . being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, - (S)he is the 1M d,Ir"` �iC. '' D V 1 8 °� L (Contractor,Agent,Corporate Officer,etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his/her knowledge and belief;and that the work will be performed in the manner set forth In the application file therewith. fen Sworn before me this day of GaV KR-- .20] 'Nc6ry Public SETH G BANK rrr �a'Yg r� Notary Public-State of New York PROPERTY OWNER AUTHORIZATION NO.01BA6427783 Qualified in Suffolk county (Where the applicant is not the owner) My commission Expires Jan 3,20 I,—af�L �Ji �� residing at Ar do hereby authorize to apply on my behalf to the Town of Southold Building Department for approval as described herein. o� Owner's Sal GGre Date Print Owner's Name 2 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Received Town Hall Southold, N.Y. ��c7 MAR o.s zozs CERTIFICATE OF OCCUPANCY Zoning Board of Appeals No Z-22014 Date DE ER 8 1992 THIS CERTIFIES that the buildingR & AL T1ON Location of Property 1875 JACKSON STRJMT NEW SUFFOLKA NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 9 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 9 1990 ursuant to which Building Permit No. 18854-Z dated MARCH 9 1990 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 REPAIR & ALTEPATION TO EXISTING ONE FAMILY DWELLING The certificate is issued to MICHALE GILL & BARBARA B WORTH (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH AP"P"ROVAL N A. UNDERWRITERS CERTIFICATE NO. N-181156 - MARCH 29 1991 PLUMBERS CERTIFICATION DATED NOV. 9 1990-PECONIC PLUMB. & HEAT. Building Inspector Rev. 1/81 ROr ! TOWN OF SOUTHOLD BUILDING DEPARTMENT Received TOWN HALL SOUTHOLD, N. Y. MAR Q.6 2026 Zoning Board of Appeais BUILDING PRWIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 18854 z ,q1'� 19. d .. Date .�1.�......F.................... ..., ..� 14 Permission is hereby granted .. ,.« . ...... .«.. ............................]/ �w �Y}� �.pwr to ........ « �7M«Y F«.�.s►r.... •««. . .........r a « .«w ««r.w.w wwr .�«..Aw« .. at premises located at .,..... ...... . ..t ...... . . « .... . ..... . ... ............«.« ... ......«.««.................«...«......«.......... . «'. .. . .. ... ...« .....3 x... ................... .................................................... . .. .i'•.. ... ....�.w......................, ro...,......0.. ...............,...................... County Tax Map No. 1000 Section ...zl.7...... Block .........I.......... Lot NO. ....l....�/........ pursuant to application dated ........../../..,�... - •.•••.•• .......... 19.1��., and approved by the Building Inspector. Fee -a, eve.... �.. Buildi Rev. 6/30/80 BOARD OF N �1;TH ..---- 77�=, 1 SETS OF NS ....... FORM NO.1 SURVEY ........ .. TOWV OF SOUTHOLD CHECK ............-. . .... .-». BUILDING DEPARTMENT SEPTIC FOR;t TOWN HALL NOTIFY ,. 1OW",tILOG SOUTHOLD.NY. 11971 CALL �. .. «. ....,., TEL..7GS•1802 MAIL To: w ,ived Examined�....� '&............. , 19... p Approved !!F1t ..1....... 19%6-rmit No../.4.G p 1-Y z MAR a 6 2026 Disapproved a/c .............. ...........,».......... Zonina Hoard of Appear ...&Wz* (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 19.. INSTRUCTIONS a. This application must be completely filled in by typewriter Orin ink and submitted to the Building Inspector,with: sets of plans.,accurate plot plan to sole. Fee according to schedule. b. Plot plate showing location of lot and of'buildings on premises,relationship to adjoining premises or public street or areas,and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli cation. C. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application,the Building Inspector will issued a Building Permit to the applicant. Such permi shall be kept on the premises available for inspection throughout the work.. e. No building shall be occupied or used in whole Orin part for any purpose whatever until a Certificate of Occupant: shall have been granted by the Building Inspector. '' APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York,and other applicable Laws,Ordinances c Regulations, for the construction of buildings,additions or at or for removal,or demolition,as heroin describe, The applicant agrees to comply with all applicable laws,ordinances, building code,housing code,and regulations,and t admit authorized inspectors on premises and in building for necessary ins lions. f� ... .id, .... (Signatatre o applicant,or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde .......................[�.�:1 .c�Q .................. ue:e. ................... Name of owner of premises .. ..... ..... �(as on the tax roll or latest deed) if applicant is a corporation,signature of duty authorized officer. .. w .. (Nam and title of corporate officer). . ..... , ALL CONTRACTOR'S MUST SUFFOLK COUNTY LICENSED Builder's license Ni. . .`d�-.. :.1#:�.s...... Plunger's License No. mega e� Electrician's License No. ,, ?A 49.1:1,— 4:-T.r. led Other Trade's License No. ..................... K 1. Location of Iand an which proposed work will be done. ............... ................................ .. ,....J.,17 .........S:aK.�ah...STYeeT....... House Number ff Street Hmnlet w County Tax Aiap No. 1000 Section ....i.r.(......... Block .. .............. Lot .,..„„ ...,., Subdivision.... ........... ........ ........ Filed Map No. .............. Lot ............. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing useand occupancy ...... .._................... ......... ....... b.Intended use and occupancy ...... .�.5:d eti:? aL ._ :.� �............... 3- Nature of work(check which applica \ New Building ....:..... Addition Alteration .. ,,,, Repair .............. Removal .............. Demolition ,.. .., . Other Wor .. ......... �t �. ke a,r wcriplio ) 4. Estimated Cost .. 16 p e a......,.....................„ Fee ,...» . ........., ... »; ik etc % (to be paid on ing S. If dwelling,number of dwelling units ........0...... Number of dwelling units on each lflo r..application)»,.. Ifgarage,number of cars .... .. .... .»..... ..I............I» .,.. .............................. ` 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use ...... 7. Dimensions of existing structures,if any: Front ... .. Rear .,.»s �a..... Depth iVe Height .. ..... . ...."A7,r ....Number of Stories ..... . A.. ..... . lR ..., ..V........... Dimensions of same structure with alterations or additi ns:Front ....�. .. ..... .•Read � Y pR: s. �6 Depth ........,3G..........Ilciglrt .... ...,.,.. ».,Number or Stories tf,�C .. S. Dimensions of entire new construction: Front ................ Rear .......... Depth ............ Height ....._....... a nbe of Stories ......b�4 » .......... .. tan ; -20 rd•of-Appeals 9. Size of lot:•Front ....... X.Z.... ... Rear. ; V..». ..... Depth J;,�"a.............. 0. Date of Purchase MgrPh rJ.T.T Q................Natne of Former Ow .�41 iF.-V .. ........ 1. Zone or use district in which premises are situated.....,,..r- fi r..... • ... •..•• 2. Does proposed construction violate any.toning law,ordinance or regulation: .N-a......... ...».. ........9 3. Will lot be regraded ., �. f J4.es� �r y�,excess fill be removed from premises.: �y es 4. blame of Owner of.premise� . . "°:t.i.i»..,,A dress . . to e.rWl�..Phone No.' SJJ.:—: '4� f. Name of Architect ....» r�r .......Address �•� ... ..Phone No .� Name of Contractor ��41w'� �?aNl1?'i A...Address .�»�5��'�c.+����,.Phone No .S. is this property locat within 300 feet of a tidal wetland? Yeti • No •`� *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from •roperty lines.Give street and block number or description according to deed,and_show street names and indicate whethe. ltcrior or corner lot:. I 9 f♦ N c5y ( S Tt+H LD a rATE OF NEW YORK S S 01:tiTY OF................. »µ.* . 5 ..,.,,,.. « ,,,,„ , .......... being duly sworn,deposes and says that he is the applican (.Name of individual signing contract) :ovc named. is the ........................... ........................ ........ .......................... (Contractor,agent,corporate officer,etc.) said owner or owners,and, is duly authorized to perform or have perforated the said work and to make and file thi plication:that all statements contained in.this application are true to the best of his knowledge and belief;and that th ark will be performed in the manner set forth in the application filed therewith» rorn to before me this ......... .. ....day of....�ja t 44 ........ 19;1Q. ,tary.public, ... .. �..�J. -,,... County 1g.0116. » » • (signature of applicant treutl 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 dis " All,applications requiring an agricultural data statement must be referred to the Suffolk Co ������� Department of Planning in accordance with Section 239m and 239n of the General Municipal Law. MAR ®.6 2026 1. Name of Applicant: Zackery E. Nicholson RA - ZEN Design Zoning Board of Appeals 2. Address of Applicant: PO Box 88 - CUtChO ue, NY 11935 3. Name of Land Owner(if other than Applicant): 1875 Jackson LLC 4. Address of Land Owner: 150 King Street - New Suffolk 11956 5. Description of Proposed Project: Construct a Shed dormer at an existing single famil dwellin . 6. Location of Property: (Road and Tax map Number)1875 Jackson Street - New Suffolk 11956 1000-117-9-14 7. Is the parcel within 500 feet of a farm operation? { } Yes 0(} No 8. Is this parcel actively farmed? { } Yes W 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. N/A 2. 3. 4. 5. - 6. (Please use the back of this page if there are additional property owners) Signature of Applicant Date Note: 1.The local Board will solicit comments from the owners of land identified above in order to consider the effect of the proposed action on their farm operation. Solicitations will be made by supplying a copy of this statement. 2.Comments returned to the local Board will be taken into consideration as part as the overall review of this application. 3. Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above. The cost for mailing shall be paid by the Applicant at the time the application is submitted for review. 617.20 � Receiv Appendix B MAR 0.6 2026 �I Short Environmental Assessment Form Zoning Board of Appeals Instructions for Co a feffla Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: 1875 Jackson - Proposed Shed Dormer Project Location(describe,and attach a location map): 1875 Jackson Street - New Suffolk 11956 Brief Description of Proposed Action: The proposed action consists of an area variance to allow an as built accessory patio associated with a single-family residence to remain within the required front yard setback.. The patio is primarily at grade, with a limited raised portion necessitated by existing site slope conditions. No additional building area, dwelling units, or change of use is proposed. Name of Applicant or Sponsor: Telephone:631.513.6589 1875 Jackson LLC E-Mail: ZENicholson.Arch@gmail.com Address: 150 King Street City/PO: State. Zip Code: New Suffolk New York 11956 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that X may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: X 3.a.Total acreage of the site of the proposed action? .384 acres b.Total acreage to be physically disturbed? 0 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? .384 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial XResidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 w ,z 5. Is the proposed action, I NO YES N/A p P a.A permitted use under the zoning regulations? lations? X b.Consistent with the adopted comprehensive plan? Received X 6. Is the proposed action consistent with the predominant character of the existing b�o Tr96 NO YES landscape? �q X fy proposed el w A%y#9M'$ �� a? NO YES 7. Is the site of the ro sed action located in,or does it adjoin a state hst � a If Yes,identi X 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES X b.Are public transportation service(s)available at or near the site of the proposed action? X c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: X 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: N/A 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: N/A 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? X b.Is the proposed action located in an archeological sensitive area? X 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? X b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? X If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 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 ❑ 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? X 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, X 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❑YES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment � NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: v 19.Has the site of the proposed action or an adjoining property been the location of an 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: X I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE ppli�a�non�so,nam�e Date:Signa 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 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 eneLU conservation or renewable ener 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 o,or Moderate Receive mall to large impact impact MAR 0,6 0*y may occur occur 10. Will the proposed action result in an increase in the potential for erosion,floo d8,6We ofi APP08 problems? 4 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. Cl 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 iiD B2ard of Zoning Appeals Application Received OWNER'S AUTHORIZATION MAR 0.6 2026 (Where the Applicant is not the Owner) Zoning Board of, Appeals I, David Noonan residing at 150 King Street (Print property owner's name) (Mailing Address) do hereby authorize (Agent) Zackery E. Nicholson, RA to apply for variance(s) on my behalf from the Southold Zoning Board of Appeals. By signing this document,the Property Owner understands that pursuant to Chapter 280- 146(B)of the Code of the Town of Southold any variance granted by the Board of Appeals shall become null and void where a Certificate of Occupancy has not been procured,and/or a subdivision map has not been filed with the Suffolk County Clerk,within three(3)years from the date such variance was granted. The Board of Appeals may,upon written request prior to the date of expiration,grant an extension not to exceed three(3)consecutive one(1)year terms. IT IS THE PROPERTY gWNERIS RESPONSIBILITY TO ENSURE COM L1A CE WITH THE CODE REQUIRED TIME, RAM DESCRIBED HEREIN. L (Owner's Signature) David Noonan (Print Owner's Name) FOR COUNTY USE 616 _S Code " =1NS):tnlvrW.orps.slal ' mre Dees Recorded 11- 148 7 N 18 r 2 O: 3( tom. of tk Day YeNsz. New York te, IIVV altldo �FUN i5rlipvtty Tax fff+rlCs' C3_ boot LL.312 1 l r 9 I 16 2 t 7 Real Pro C4. Page 1 RP_.5, PROPERTY.INFORI4W:EON t.Property 1875 zone 01 aack9.on Street, Board Oz Location - •.axnsorwxae+tnan. ..,,.�.,� �...,�.....,,... •ofaeeTn Southold New Suffolk 11956 •crtraeTowN vliu Q 2(�U 'sn•coot 2.Buyer 1875 Jaak'son LLC MAY 2 O Name •LAOTNAMWCOEa`ANY riet Tetnrrti. •••••• LAST NM.SE/GOMVAI•Y .. '" 3.Tax Indicate Wfunbfdtlu're Tax Bills afo to be-sent...... Z�N�NGBOARD Bilfing if iher than buyer"adtirrass(ot bottom of form)"`""'"e:wltrrMm&aArtrxi'an Arp'Y -^� rmsr NAr,s Address �,...e_...,.. _- .--._.... iMTEET NUMBCQANa NAMa CITY Oa'rmYJN b A= 21P COOL 4.Indtcatotha number of Assessment 1 LJ Part-fa Parcel (duly if Part of a Parcel)Check as they apply. Roil parcola transferred art the dy ed #of PNrrcels OR 1-1 4A.Planning-8oatd"Walh;SubNftNsion Authority E><Ists t 1 G.Deed _ _ X •OR 0.125 4B.Subdivision Approval was'Required for Transfof 0 Property PRelrr rpeT. •naTTil •ACRES -- l--1 Size 4C.Parcel Approved for Subdivision With'Map PrcrAded' t_J Gill, as, Trustee Mtchael E_ ,GW;rw ,..._ •LAaT r NArdCrCClYAPAhw o�rA'e Nome LAeT MAe6 ,,ANY n«..... ••••.lrrraT WA4t rwoa- =3 BulteT,h, .s Trustee ' a a -7.Select the description which most:accurately.describes the Chack,lhe box0s below as May appry: f�1 uso-ofthe property at the erne of sales 6.Ownership Type Is Gondemlnlurn tTl A. One Family Residential 9.New Conauuction on a'Vacant Lend 0 .«..«...»-«..-. JOA.Property Located YAIWn an AgrfeuRurat District " 10A Brtyer'repq'tJDKad a apeclo'sura noliee IndicaWtg Thal the property is In an 0r-^� ngfieallumfiatrlol ' �dt,I,.E Il^dF Itl "t`t.:N' 10,firtoaak ono or mom adf taettao�aad'ttNonaas appnaa4 a totranafmr;'.. A.Sale'Setween Relatives w Former Relatives 11.Sato Contract-Date 0.6/02"/2 0 2 3 B.Sale between Related Companies or Partners Irf.8dWness. ,.-.- - C.One ofthe Buyers is also'a:Sellor O,Bt y6,('or t3aller In 'ovd,n rent�thgdpcy,or treit&rjg Inslitutiorl t 12.Date of Saterrraneter .M1 .., " �,. 3. E.13oad"typ's,no wartanitr er'.Bargatn and Sets(Specify eek w^) F.$Me ql Frrar tidnat or Low lbor Foo lnl ivo('Spdclly Below) •13.Fult"Sato Price 1,250,000;U0 G 40 dilcarlt.Chants,In Property Between Toxretaie.Stotua Old Sale Dates H.gala of Bu4nos t Is hicluded to Sala price "(Full Sole Price Is the total amount paid W eha pioperty forJuding.personrd property. I, Other Unusual Factors Affecting Sale Price-(Spedly Below) We payment maybe In the form of cash,other property or 97odo,.or the assumption of J.None mortgages or other obligations,)Pfoasc round to Me acamstxhole dbflar amount. -' Rrdninaelt(s),on CondlNon: 14.Indicate the Value of personal 00 propaAty Included in Me safe A>S 'S'BNIE I4FORMATION-PS(ci sMoWd ralleCt this late st FNrta) ¢O:ffast:Olr}dl'MtRoll afld'Taat'..f)'iIt 16•Year of Assessment Rott from which Information taken(YY) 23 '17.Total Assessed Value 6,200 •46_Property Crass 2.10 '19•School District Name New Suf fol% -2e_Tax Map Identillor(s)1Ra11 Identiner(s)(if more than four,attach sheetwllh additional IdentiHer(s)) lobo-117.00-09.00-014.000 t Corilfy that all of the items of lnformyLtlaft antarod on flits farm are bus and correct Its the,bol dt of my knoWladlio and ttaDef)and"I urdumtand that:the.making 01'any witdful fiat stataraanto'f'martNtrlol fact.'learola subject m-o to t���,SttY.tf19.Y0 .at9C3 r:pfxttwt(.f: t.rotativo to the moktnS and pflm,s of false titairtlnrarm s. � �„9( '�fup„FAC'f'fNFC3�ItNgItA'1'10Ci1 ,N Illhtortntermoopn see"lim"r,Hoke 11#1f orla tl c,seoiaty,m#cofr6 N.wiparaam„)pan Mooek ocmporvy.ddkk W 4 '" Rl., It erltOYr a+ati oral Nee tno4duat infant Orr itowAaw.there a uaawar and tor+xgcN kNraaNroaoew seers tladrn9aoraWos'po,uWtllo 9 y f4,eyvdpaaoaaouworrdww tnrnereanpimgttwtremiorpuorbowtomd Typl+rApHraakradya ae rtaNmxrATu dates 1875 Jackson LLC ­.W _ prrNnpeO' . 725-6300 •ARCH CaDE ^aiTtlJa'wYGgar PWdNtwlNn"M4 tCa'.TMTaerapl aMYr! arer ..,..•"...„ eAfa (SpKinq Street, P. O. Box �6 More,wraNMii "'"+aTesysr era uwwi( L No%W Su!f:it lk .� NY 11956 •ca'rY on ro", •Tmv', •YIP cecn k�LlX���.A�LP�E.IC . a,r'ern, Esq. Valerie LA97 A(AFnC" •,—•—••.•x••••:•,••.••.•. NPASAi iMPNdlu'•.•••• d r AR Fr coed X'6LGt%MWNSF glyNua�W r,n,trrwaPt ADDENDUM TO RP- 5217 necwaeceived MAY 2 g 2025LIAR 0.6 2026 Grantor.:'' ZONINGZZoom B0 of Appeals BOARD OFgPPBAL Michael E. Gill.and Barbara Butterworth, as Trustees of the B. Butterworth ;and-M. Gi'II,Trust dated February 19, 1994. {y I N RECEIVE© MAY 2 8 2025 11111111 IN 11111111111111111111111.111.111111111.1111 ICI ZONING BOARD OF APPEAL: Illlll �III�,I� IIII�III�I Received MAR 0 6 2026 SUFFOLK COUNTY CLERK Zoning Board of Appeals RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 8/18/2023 Number of Pages: 4 At: 7:44:06 PM Receipt Number.: 23-0106309 *ELECTRONICALLY RECORDED* Transfer Tax Number: 23-02251 LIBER: D00013214 ,PAGE: 627 District: Section: Block: Lot: 1000 117.00 .09.00 014.000 EXAMINED AND CHARGED AS FOLLOWS Deed Amount $1;250,000.00 Received the 'Following Fees For Above Instrument Exempt Exempt Page,/Filing $20.00 NO Handling $20-00 NO C.OE $.5.00 NO NYS SRCHG $15.00 NO Notation $0.GO NO Cert.Coples $0.00 NO RPT $200.00 NO Mansion Tax , $1-2,500.00 NO EA-CTY $5.00 NO EA-STATE 0125.00 NO TP-584 $5.00 NO COmm.Pre's $26,250.00 NO Transfer .Tax $5,000.00 NO Transfer Tax Number" 23-02251 Fees Paid $44,145.00 THIS PAGE IS A PART .OF THE INSTRUMENT THIS IS NOT A BILL . Vincent Puleo County Clerk, Suffolk County . R 1 kDED 4 � /18 Numberof pages /2. 4:06 ,PV1 t VINCENT P_ULEO 1 CLERK OF eceived Treis-do .mertl:z�11 be public SUFFOLK COUNT record, pleaSetemove er L D000.13214 -Sodas security Numbers P 627' LIAR 4 6 2026 23=02251 prior t6 recording. g geT�axSNamp Reaord'm�!,SIJng 0 of Appeals DoodJ Gad e' Irislr,�rneM Deedli+Rart a FEE Mortgage Ard. -UgCE �p l Pago 1 Filing Fee 1.Basic Tax O Handling 2, Additional Tax � Tt-2025 TP-584 5.00 SubTotall NofaWn 0.00. Spec lAssd... 5.Oo 50.00 or ZONING BOARD OF APPEALS EAS217(County) -SubTotal Spec,lAdd. 125.00- TOT.MTG.TAX 5A r217(State!) - -200.00 Dual Town Dual County R:P:T.S.k 116d fQr.Apgoin"ent Comm.of Ed. 5 00 TsansferTax 5.,000..00 Affidavit + Mansion Tax 12,SpO' 00 The property coveroO by this mortgage i= Certified Copy, 0:00 or vA tro Irrtpt'oved 6y a one or;two M'S Surcharge 15. 00 3 5.00" family diwPing only., u T tai YES_--or O Other O 3g15.-00 ` mnd'Total If NO,see appropriate tax clause on page* of ails instrument. 4 Dist. Section Block Lot 5.iCotmtm.wt* Reservation Fund 2302,082 F?oaI Property a.r N Eotrsirleration A=Luit. 1,250,000.00 TaxService n ova 26,250.00 Agancy rraeazoza CPFTaxx Due. $ Verification �Improved x f1 a rs� Dori A t3 ses b rope nets of rig ,, RECORD&RETURN TR; VazOnt l.arf d Advantage Title TD 10 201 old country Etd Ste 200 Melville NY 11747-2731 TL) v, Wilto: Vincent Puleo,Suffoik-County Clerk 7 Title Company-lnfarmabon, 31Q Center Drive, Riverhead, NY 11901 OD.Name -www.suffolkcountyny.govlclerk. TA- $ y � :.�� �+���nt :� � � Endorsement age This page forms part of the attached DER) made by: ( P'dOIFYTYf t F'1tlaTRUt IENT) flteprerra�esherein isstittlated in SUFFOLK COUNTY, NEW YORK. -TO Ireftw TOWN of SOUTHOLD Inths1 ILLAGE. or liA@ItL:T of BOXE56 TMU S MUST BETEPEO OR PRINTED IN BLACK 1NK C4d:Y FRIORTO RECORDING OR FILING. 0 BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S Received ACTS(INDIVIDUAL OR CORPORATION) STANDARD NYBTU FORM 8007 �0 R 06 2026 CAUTION'THIS AGREEMENT SHOULD BE PREPARED BY AN ATTORNEY AND REVIEWED BY ATTORNEYS FOR SELLER AND Piece ft PURCHASER BEFORE SIGNING. AA THrs INDENTURE,made'the day of sly 2023 MAY 7PrT1k � Tei of pealS between r' t87 .J1 MT�E E.GTLL and BARBA'ltA BUTT)R'4'�'O "1"B TRUSTEES OF THE B. ZONING"QARD OF qPP BUTTERWORTH AND.1vL GE ILL TRUST dated February 1 ,1994 FALS residing at 12636 New Suffolk Avenue,Cutchogue,`NY 1193.5 party.of the first part,and 1875 JACKSON LLC residing st,150 King Streei,P.O.Box 66,New Suffolk,NY 11956 party of the second part, WITNESSETH,that the party of the first part,in consideration of One Million Two Hundred Fifty Thousand and 00/100($1,250,000.00),lawful money of the United States,paid by the party of She Second part, does hereby grant and release unto.the party of the second part,the heirs or successors and.assigns of the party of the.second part forever, ALL that certain plot,piece or parcel of land,with the buildings and improvements thereon erected; situate,lying and being in the Town of Southold,County of Suffolk and State of New York. SEE SCHEDULE`A'ATTACHED HERETO AND MADE A PART HEREOF Being the same premises described in the deed to the parties of the first part herein from Michael E.Gill and Barbara Butterworth,as tenants by the entirety,dated February 19,1994 and recorded on July 29,1994 in Liber 11687 Page 507. Said premises are known and designated as District 1000,Section 117.00,Block 09.00 and Lot 014.000. TOGETHER with all right,title and interest,if any,of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof, TOGETHER with the appuitenances and all the estate and rights of the party ofthe first part in and to said premises, TOHAVEAND TO HOLD the premises herein granted unto the party ofthe.second part,the heirs or successors and assigns of the party of the second part forever. AND the party of the first part,covenants that the party of the first part'has not done or suffered anything whereby the said premises have been encumbered in anyway whatever,except as aforesaid. AND the party of the first part;in compliance with Section 13 of the Lien Law,covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before-using any part of the total of the same 'for any other purpose. The word,"party"shall be construed as if it read"parties"--whenever the sense of this.indenture so requires. IN WITNESS WHEREOF,the party of the first part has duly executed this deed the day and year first bD;YP,,written. MTCHAEL E.GILL,tr BARBARA BUTTERW ORT11„Trustee NYSBA Residential Real Estate Forms on HotDocsm(9/00) Copyright CapsoRe Development -1- r S\Au 9wol MAY 2 8 2025 STATE OF NEW YORK ) ' ss.t COUNTY OF SUFFOLK ) ZONING BOARMSqMd On the to day of 1.� ,in the year 2023,before me,the a tul'ersigned personally appeared. Michael E.Gill and Dai barn But'r worth,personally 4nown to me-or proved tome on The basis of satisfactory MAR 06 2026 evidence to be the individuals whose names ere subscribed to the within instrmnent4nd acknowledged to me that they executed the same in their capacity;that by their signatures on the instrument,the individual,or the person upon behalf'ofwhich the individual acted,executed the instrument. Zoning Board of Appeals NOTARY PUBLIC , catty NOWOMt wacaaaw tw,rauc,srnte of tttrra�rotprc w prppsarataon t4 61 cl�ap�,iad td s�9ltatt a»prpmkaxGoaaa�1�' 2rfE$ r DEED District 1000 , Section 117,00 Block 09600 GILL&BUTTERWORTH Lot 014.000 TRUST County or Town SUFFOLK To " 1875 JACKSON LLC Retutrtt.I1 Mail To: Valerie Marvin,Esq. 62 Main Street,2"a Floor P.O.Box 3163 Sag Harbor,NY 11963 Reserve This Space For Use Of Recording Office NYSBA Residen"Reel Esmte Fommon Ho0=6("o) Copyright Capsoft*Development -2- RECEIVED W MAY 2 8 2025 . , SUEDwived OF APPEALS MAR ®6 2026 Amended:6-3.0 2023 Zoning Board of Appeals ALL that certain plot,piece-or parcel of land,situate.; lying and being in the Town of Sguthold.,'Couhty of Suffolk and State of New York bounded and described as follows: SEGINN.ING'at the corhe'r formed by the intersection of the Northerly-side of.Jackson Street with.the Westerly side of Fourth Avenue; ;... ,p RUNNING THENCE North: 85 degrees 42;minutes 39. seconds,West'along.the Northerly side:of Jackson-Street,.111:91 feet to land now or formerly of Thomas McKenzie; THENCE North 05 degrees 19'minutes 00 seconds East along the last mentioned land,150.00 feet to a.concrete monument.and land now or formerly of Whitecap North Fork:LLC; THENCE South:85.degrees 43 minutes 10 seconds East along the.last mentioned aand,ll'1.08 feet to tho-Westerly'side of-Fourth Avenue; THENCE South:04 degrees'59.minutes 50.seconds West along the-Westerly side of Fourth'Avenue, 150.004.eet-t6tthe corner,at,the point;or.,place of BEGINNING. The policy°to lie Issued under this report.wltl insure.the dUe to:sueh buildings end imprdvemeuts erected on FOR the prettbes:whiah by law conaltule renal property. CONVEYANCING •ONLY. TOGETHER with all the right;title and ititerest of the:party of the.first part,,of,in and"to the laud lyIng"in the street Ita groat,ofard,adoning said premises: TITLE'#23-AS;,6.0052 AGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM ` O The Town of Southold's Code of Ethicsro i'its onfl'icts of interest op t e PaLt of town,officers and enA to ecs.The-puERose of this form is to proylge`n rmation which can alert the town i sl l conflicts of interest and a o it to take whatever actlon is ageggsM to avoid same. Received YOUR NAME : Zackery E. Nich olsom (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such 9VV�l s�� 2026 company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) coning Boao 01 Appeals Tax grievance Building Permit Nz 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 applicantlagent/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 /3 ry PISS. Submitted this day of 2026 Signature MM,,, Print Name zc KE. Nicholson,_ RA APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM �y 1 The"1 own f oath ld's Code of Ethics orohibits conflicts of interest on the gart of tomm officers and empluees.The purpose of this form is to provide inf rmation which can alert the t wn 9f s ile confli is of'i,nterest and ail w It to take wjigt±ver action is necessary to avoid same. YOUR NAME : David Noonan Received (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.) MAR A_S 2026 TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit ,-_ Zoning Board'of Appeals 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 I,g w Submitted this 240 day of 2026 Signature Print Name- David Noonan 'Town of Southold 4� LWRP CON5ISTENCY ASSESSMENT FORD deceived <�� MAR ®6 2026 A. INSTRUCTIONS Zoning Boars; of kppcals 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 undertakes. 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# 117 14 The Application has been submitted to(check appropriate response): Town Board R Planning Dept. D Building Dept. © Board of Trustees D 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital construction,planning activity, agency regulation,land transaction) r (b) Financial assistance(e.g. grant,loan,subsidy) (c) Permit, approval,license,certification: D Nature and extent of action: The proposed action consists of an area variance to allow an as built accessory patio associated with a single-family residence to remain within the required front yard setback. The patio is primarily at grade, with a limited raised portion necessitated by existing site slope conditions. No additional building area, dwelling units, or change of use is proposed. % I Location of action: 1875 Jackson Street - New Suffolk 11956 Site acreage: 0.384 Received -10 Present land use: Sign le Family Dwelling MAR 0 6 2026 Present zoning classification: R-40 Zoning Board of Appeals 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: Zacke E. Nicholson RA (b) Mailing address: PO Box 88 - Cutcho ue New York 11935 (c) Telephone number:Area Code 6al. 1 (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 EJNo In Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LVWRP Section III—Policies Pages 3 through 6 for evaluation criteria 11 Yes ❑ No 0 Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the eA old. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria MAR 06 2026 V0 ® Yes [1] No I rj Not Applicable The proposed action: will not adversely affect visual auality or scenic resourc W Anne Is accessory to an existing single-family residence and remains Iar el at arade. The installation is consistent with the residential character of the nei hborhood and is visuall softened b surroundin landsca in . No scenic vistaspublic viewsheds or designated scenic resources are impacted. 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 11 No ® Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria Yes No ®Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. Yes No© Not Applicable Attach additional sheets if necessary Policy 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. 13 Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LVWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. E3 Yes 1:1 No® Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LNVRP Section III—Policies; Pages 65 through 68 for evaluation criteria. Yes ❑ No ® Not Applicable Created on 512510511:20 AM y n r t as � s a s �7 1875 Jackson S New Suffolk �� Photos taken December OWNER VILLAGE ST REET 1 `� DISTRICT SUB. LOT s _ - e,e = 0 FORMER OWNER :, �'.� ; N - e r• ri S W TYPE OF BUIL IN Res. SEAS VL FARM COMM. IND CB MISC. Est. Mk7s Value LAND IMP. TOTAL DATE REMARKSA2 rz YJ v a Sty no z (n1e-A tod AGE BUILDING CONDITION r _ 7 NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre 'Value Per Rise Value FRONTAGE ON ROAD Tillable 1 BULKHEAD Tillable 2 s � _ DOCK Tillable 3 1 O Woodland Swampland 0)Brushland - rNL __ W, }-louse Plot d 4 s a I � Total - 4 �e � e. 3 a - Q 7 r � �ensian SasererA dors m r N i a ,o �, W Interior Finish eo - Extensront �E,/ ® �y Cire �e kcal Porch � R-ouf Type _ �are€� _ r� s# Four m c c _ E�reezeKr�Y F'�tio R,orris end door e (aQrcge v 5 �: 6rivewoy� D:.rMLr _ =s s _ . 4 Tcft So FT f V - o C., CD 0 Mon 7 OD Ir M, �Lc dz0 �, S Foundation PC eR Bath Dinette Extension ti P `,l 4 r `� Basement Floors Kit V t _ - Extension �'' ° mot'` - i?� r4 FinishedB. - Interior Finish 1L� L_R Extension _, F � i„tca. Meat D.R �_ l Garage Ext. Walls Color f3R Trim Porch Dormer Baths Deck/Pe ' - ' ` 1� 1 ��y Roof Fin'®"SO FT Fam. Rm V �. Sr � N � � 1st Flr Pool _ C.l� -j- J.f } Solar Fir f A.0 IGEN - V end Flr - Laundry 1 O.B -- Library/ Study V Dock t