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HomeMy WebLinkAbout#8119-Murphy-Foster ZBA application U 7 « a FORM NO. 3 TOWN OF SOUTHOLD Received DEPARTMENT SOUTHOLD,N.Y. APR 112026 NOTICE OF DISAPPROVAL Zoning Board of Appeals DATE: February 6, 2026 TO Miriam Foster PO BOX 115 Orient,NY, 11957 Please take notice that your application received: January 29, 2026 r For permit to: to construct an addition to an existing single-family dwelling at: Location of property: 595 Youngs Road, Orient, NY County Tax Map No. 1000— Section 18 Block 1 Lot 6,_3 Is returned herewith and disapproved on the following grounds: The construction on this 17 021.40 s , ft. parcel in the Residential R-40 District. is not ermitted pursuant Article XXIII 20-124 rihic states lots rneasurin less than 20,000 sf re ire a minimum rear yard setback of 35 feet. The construction as shown on the survey,has a rear yard,setback of 20 feet. V' Au rued Signature Note to Applicant: Any change or deviation to the above referenced application may require further review by the Southold Town Building Department. CC: Me,Z.B.A. Received APPLICATION TO THE SOUTIIOLD TOWN BOARD OF APP&fi 13 2026 AREA VARIANCE House No. '5q5 Street Youm Cs fR D Hamlet OR l am' Board of Appeals j71074 0 SCTM 1000 Section: 18 Block: / Lot(s) Lot Size: 0., 2 *,06:�Zone D I (WE)APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED 2 _ _2-Lm BASED ON SURVEYISITE PLAN DATED ./4. 2025' Owner(s): M IfC l M * C-aAY56 t4 MU RPRY Mailing Address: 5,TS y U UN6`S t"-Z,fl . D(Z►ErJ-r Telephone:Q 56-367-X20 Fag: i.i A Email: 0r nen+Co0&J+r j SkbY-Q � � l.Con'►- NOTE:In addition to the u v 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: ,A6AtJ CWaAe0ZS for KOwner( ) Other: Address: r-D. 90V -1 cS O►)ThOLb N`( 11 Ct,1 Telephone:63/"2-R'l-'F / Fag: luk Email: r tit • Corn Please check to specify who you wish carrespondeuce to be mailed to,from the above names: P'Applicant/Owner(s), Authoried Representative, ( ) Other Name/Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN DATED &Iq.• 2o2 S and DENIED AN APPLICATION DATED FOR: J4 Building Permit ( ) Certificate of Occupancy ( )Pre-Certificate of Occupancy ( ) Change of Use ( )Permit for As-Built Construction O Other: Provision of the Zoning Ordinance Appealed. (Indicate Article,Section,Subsection of Zoning Ordinance b q y ntnmbers.Do not note the code.) Article: 1 ISection: 2g (2A- Subsection: Te of A yp p eal. An Appeal is made for: 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 ( )Request for Reversal or Overturn the Zoning Officer's Denial Other A prior appeal has, 10 has not been made at an time with res ect to this pr0erty UNDER Appeal No(s). Year(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 See� A, Received (Please be specific,additional sheets may be used with preparer's signature notarized): APR 1:3 2026 1.An undesirable change will not be produced in the CHARACTER of the neighboRWhOtMan roof Appeals nearby properties if granted,because: 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: 3.The amount of relief requested is not substantial because: 4. The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: 5.Has the alleged difficulty been self created? I%Oes, or { }No Why: • Are there any Covenants or Restrictions concerning this land? 14No { )Yes(please furnish a copy) r 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 mar has not been filed with the Suffolk County Clerk,within three 01 yeas ars from the elate.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 Appli t or Authorized Agent (Agent must submit 'i"en Authorization from Owner) Sworn to before me this da CONNIE D.BUNCH L, y Notary Public,State of New York of AA C I 20 No.01 BU6185050 �/_— No. in Suffolk County D Commission Expires April 14,2C7 Notary Public 3 Foster/Murphy Property Receive 595 Youngs Rd. Orient APR 13 2026 1000-18-1-6.3 Attachment#1 Zoning Board o- peals 1. An undesirable change will not be produced in the character of the neighborhood or a detriment to nearby properties if granted because: This is a neighborhood of generally small lots. Of the adjacent properties four of them are less than an acre, 8 of them are a half acre or less and only three are larger than 1 acre which leads to a neighborhood with generally cramped back yards and close neighbors. The property in question is .39 acre and limited in area in which to expand. Those limits are further exacerbated by the unusual angle to the rear yard property line. The property to the west which would be most affected by the proximity of the proposed addition contains a road, Pete Hill Rd. which runs from the Main Rd. in Orient up to the Long Island Sound and this road makes any future building near the proposed addition highly unlikely, if not impossible. 2. The benefit sought by the applicant cannot be achieved by some method feasible for the applicant to pursue, other than the area variance, because: If the proposed addition were to be relocated to the south on the property to increase the amount of setback from the rear property line it would require the relocation of utilities and potentially the septic system. It would also bring the proposed patio, the private area of the addition, closer to the adjacent properties at 517 Youngs Rd and 494 Youngs Rd. The property at 517 Youngs Rd. is setback only ()from the north property line. If the proposed addition were relocated south it would also bring it closer to the .41 acres of"right of way"that sees a substantial amount of traffic as it serves seven other lots. 3. The amount of relief requested is not substantial because: In its current configuration this lot requires a substantial variance to accommodate the proposed addition but the owners have approached the landowner to the west who owns 2.61 acres, including a section of Pete Hill Rd. and entered into negotiations to purchase enough land to "square off'the rear of the owners' property. Unfortunately the landowner is in poor health and will not be able to conclude these negotiations in the near future. 4. The variance will not have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: The existing residence is one story and 1360 sq.ft. which is similar in size or smaller than the majority of homes in the neighborhood and the proposed addition is a modest 500 sq.ft. and will be built with all drainage systems to current code so we anticipate that the proposed construction will not have a negative impact on the current environment. 4 V` Zoning Board of Appeals Received APPLICANT'S PROJECT DESCRIPTION Sb&N C tttMOM5 ( 'T) pi�i- APR 13 202E APPLICANT: LAMI, C")2j#0 MQ ftfily SCTM No. 1000 - 18 - 1 -G.3 1.For Demolition of Existing Building Areas Zoning Board of Appeals Please describe areas being removed: N.A. f e"ct- K &tj "V m ptC 'Ca AN �E�t . 1=0 la �,N t N OQ STz ietr• s' BE . ZE or✓ t "t'x . U.New Construction Areas(New Dwelling or New Additions/Extensions): 1,l l�q`�au' -ti P&o +Sf•* I �IADD9-no� " Dimensions of first floor extension: 2 4 - X 2 a -5 Y2 1p '-35- e % mo o" Dimensions of new second floor: NA D0 on, rz. Dimensions of floor above second level: M•/k. Height(from existing natural grade): '-0" Is basement or lowest floor area being constructed?If yes,please provide height(above ground)measured from natural e iming 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: Tl) eS tt Cam' w 14 B@DKMS CA M. Rrn. L-W,KA• 41 K tr. Duo.V.;a Cory%-So.. Number of Floors and Changes WITH Alterations: 1 61-4 V41 5S IV.Calculations of building areas and lot coverage,sky plane(From Surveyor,Design Professional): Existing square footage of buildings on your property: .. tit ate-- 6 �- 0 8� Proposed increase of building coverage: Yh'i'io 45� + 505 5* rnVD . = 1011 " TVMt.- Square footage of your lot: 1-7 1,01U Percentage of coverage of your lot by building area(lot coverage) Gross'Floor Area WFA)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): Eyvm.traot. l's )` :. 2q-17 aM is A"Wev) For Residential lots,is project within the allowable Sky Plane? (Please refer to Chapter 280, Section 280-208 of the Town Code): 1F.L. sse_lE :Dvj&"A AaDt V.Purpose of New Construction: PAND Lttl. sFA-m -m 3,BEQatwF 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: IF9 WEn SLOVO; F('kor1 Wo9,Tvk Q(10f. La roS 10 gou6E 7.4" f ANb F(ZarA SOUTH �cpv. 0 CIF " 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. `5 R �"�ecki6/2023 QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION APR 1'3 20?8 A. Is the subject premises currently listed on the real estate market bfft?Board of .Appeals Yes ✓ No B. Are there any proposals to change or alter land contours? No ✓"des,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 h 3.)Is the property bulk headed between the wetlands area and the upland building area? NA 4.)If your property contains wetlands or pond areas,have you contacted the Office of the BOARD OF TRUSTEES for its determination of jurisdiction? NO 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? N O E. Are there any patios,concrete barriers,bulkheads or fences that exist that are not shown on the survey that you are submitting? No 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? N o If yes,please submit a copy of your building permit and survey as approved by the Building Department and please describe scope of work: N•k. 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? N o If yes,please label the proximity of your lands on your survey and identify the Suffolk County Tax Map No. I. Please list present use or operations conducted at your property,and/or the proposed use tN G Fitt, CIO E J. (examples:existing single family,proposed:same with garage,pool or other) 3.7.1(e Authorized signature Date FORM NO.4 TOWN OF SOUTHOLD Received, BUILDING DISPARTN NT Office of the Town I � � APR 13 2026 Southold,N.Y. Zoning Board of Appeais. Ca4wel NO. .Z 3.1.Q26. . . Date . . .. . Jurl$.9. . .. . . . . .. . ... . . ... .$,19�2 THIS CERTIFIES that the building a . . I Z 1 ., . . . .. . .. . . . .. . . . . .. . . .. . . . . . ... . . . .. . . . Location of Property .5.7.5 . . . . . . . . „ Youn , .gsA y nue . . .. .. ... . . Orient. ... Na " County Tax Map No. 1000 Section . 0.1.8 . . . . . ..Block . . PA .. . .. . . .. .Lot .. ..MT...... . . .. . Subdivision .. %.. . .. . .. .... . . . . . ... . .. . . . . . .Filed ldap No. X . . .Lot No. X. . ».... , . . Requirements for a private one-family dwelling built prior to conforms subdantisl1i to the Appficslri h"*te(= hrddr Certificate of Dccupancy . . .4,pxa.1. 2A . . .. . . . ,.19 5.7.pursuant to which Fall No. . . . .x 1 AM. .. .. . . . . . dated . . .. . JNQ9. 9. . .. . . . . . . . . . . .. 19 82. ,was issued,and conforms to 4111 of the requirmads, of the applicable provisions of the law.The occupancy for which this certificate is issued is .. .... ... a. pr.ivaxe. .oi�e.:fauj�jy .�Wa. p . .add, accessory, one-car,garage•. . .. . . . . . The certificate l8 rSflCd t0 . . . l. .. .. . ... . ... of the aforesaid building. Suffolk County Department of Health Approval . . .n/,p. . . . . . . . . . . . .. . . . .. . . .. . .. .. ... . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . p/.r . .. . . . . . .. . . . .. .. .. . . . . . . . . . . . . .. . .. .. # . . B* .t' R�r.1A1 _ �_n. .._„a,. _..:.....,.:�. _.. �...._..._-, . -_.,. .;. .,.;,,,.,,.�..;. w. ,.m»�..� �wi.�� e u..�:_ ���m•° r Town of Southold 6/4/2022 P.O.Boa 1179 53095 Main Rd Southold,New York 11971 r�\� Received CERTIFICATE OF OCCUpANCyAPR 13 202� No: 43121, Date: 6/4/2022 THIS CERTIFIES that the building GENERATOR Location of Property: 575 Youngs Rd.,Orient SCTM#: 473889 Sec/Block/Lot: 18.4-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/17/2021 pursuant to which Building Permit No. 46746 dated 8/26/2021 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: accLssgagencratoras,a Lied faL. The certificate is issued to Degregorio,Nicole of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 46746 PLUMBERS CERTIFICATION DATED O2021 A ignature Town of Southold 2/9/2022 P.O.Box 1179 53095 Main Rd Received(7'\Southold,New York 11971 CA APR 13 2026 Zoning Board of Appeals CERTIFICATE OF OCCUPANCY No: 42767 Date: 2/9/2022 THIS CERTIFIES that the building ELECTRICAL Location of Property: 575 Youngs Rd,Orient SCTM#: 473889 Sec/Block/Lot: 18.-1-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/l/1900 pursuant to which Building Permit No. 47411 dated 2/3/2022 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: 0 a_mp overhead electric service. The certificate is issued to Degregorio,Nicole of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 47411 10/20/2022 PLUMBERS CERTIFICATION DATED Autolid Si tree. ; 1 AGRICULTURAL DATA STATEMENT R eceiVed I� ZONING BOARD OF APPEALS vl TOWN OF SOUTHOLD APR 13 2026 WHEN TO USE THIS FORM: This form must be completed by the app r�904 )sp cj'q�S Is permit,site plan approval,use variance, area variance or subdivision approval on property wr in an agricultural district OR within 500 feet of a farm operation located in an agricultural district. All applications requiring an agricultural data statement must be referred to the Suffolk County Department of Planning in accordance with Section 239m and 239n of the General Municipal Law. 1. Name of Applicant: J 6 AtJ C 2. Address of Applicant: ro C3o 4Ct Sovrj- t w [t q.—1/ 3. Name of Land Owner(if other than Applicant): M(NAM f'061tlk arj M0 9 7 4. Address of Land Owner: 515 ou N Gs eLR%>i - D Rt er-f'T- 5. Description of Proposed Project: 1twa� t 51'O R- A1>%A-n 0?p ' u 2 lam• �o ro mm C► 5 6. Location of Property: (Road and Tax map Number) 5 " ►gf,�s 90 . 0 A(eV <" t000 - l - t -&- 3 7. Is the parcel within 500 feet of a farm operation? { } Yes J;t No 8. Is this parcel actively farmed? { } Yes -�4} No 9. Name and addresses of any owner(s)of land within the agricultural district containing active farm operations. Suffolk County Tax Lot numbers will be provided to you by the Zoning Board Staff,it is your responsibility to obtain the current names and mailing addresses from the Town Assessor's Office (765-1937) or from the Real Property Tax Office located in Riverhead. NAME and ADDRESS 1. 2. 3. 4. 5. 6. (Please use the back of this page if there are additional property owners) 3 7'� � 2� Signature ofAppli nt 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. Conies 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. Received 617.20 Appendix B APR 13 2026 Short Environmental Assessment Form t�6 Zoning Board of Appeals Instructions for Cony let3n 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 noe_% rnUitPtl Name of Action or Project: SKI S --(Wtu s F—lo O K Project Location(describe,and attach a location map): (,! # NO O F C R 2S 1 N O RterJT-- Brief Description of Proposed Action: 1N AobtTlonl -rD C_-�cuST. (2,r 5VDQarAC.F PcL-0f05%017 k STD" OtO ELT 0 ©E rho p(e_M (5-4 0) AN O PA-T-t0 ( 4 S6 tf) Name of Applicant or Sponsor: Telephone: 6 31 -'2 4-4!M REP. OWN J DAr+J 61� ERs' E-Mail: oartctiax►%bacs (o AA Ares: '6ox 4� City/PO: State: Zip Code: _t I q 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: SOl)TNN� TDwN BUtCAII" 6. D°IIPT. X t� N 2oN(tJ tr BOA-2-9 3.a.Total acreage of the site of the proposed action? (li p 21,k cres • 3a k-e2Er 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? 39 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban }i(Rw•al(non-agriculture) ❑Industrial ❑Commercial XResidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑ Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, ` e w NO YES I N/A a.A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? APR 1:3 6. Is the proposed action consistent with the predominant character of the existi 'it or natural' NO YES b landscape? A Board of Appeals 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: ✓ 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: / 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: 12.11 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? VT .............. .... 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: 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 JR(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: ❑NO❑YES Page 2 of 4 i J 18.Does the proposed action include construction or other activities that result i tn:apottt ctit of e, NO I YES water or other liquids(e.g.retention pond,waste lagoon,dam)? el A If Yes,explain purpose and size: APR 1 7n7s V Bonrr4 of LM2 a kl-i 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? / If Yes,describe: Y 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 Applicant/sponsor name: 1 Date: R 2T 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 I 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 energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? R Will the nrnnnced artinn impair the nhararter nr rniality of imnnrtant hictnrir arrhaenlnainal 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 or 4 No,or Moderate APR 1'3 2026 small to large impact impact may may Zoning Board of Appe l8ccur 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 {lam or yt Received bdl Board of Zoning AgReals AgRlication APR 13 2026 Zoning Board of Appeals OWNER'S AUTHORIZATION (Where the Applicant is not the Owner) I, � S• residing at (Print property owner's name) ( ailing A dress) (" ✓" do hereby authorize &N C (Agent) 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 OWNER'S RESPONSIBILITY TO ENSURE COMPLIANCE WITH THE CODE REQUIRED TIME FRAME DESCRIBED HEREIN. ZI owne gnatui (Print Owner's Name) �S �r Received I APR 1�3 2026 1 AGENT/REPRESENTATIVE Zoning Board of Appeals TRANSACTIONAL DISCLOSURE FORM The Town:qf SgUtbold'§ f Ethigi 2robibitst t on the part gflgwn officers and eMg1oveys.Tlig s o m : t r !ddqjnformstjon,whjchcan alert,the tgwg gi possiblet of,1 terest and.Billow it to take whatever action is ny ssaa to av i,11me, YOUR NAME fin. . (bait name,first name,middle initial, ess you are applying i0then a of someone else or other entity,such as a company.If so,indicate the other person any'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 �f 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 day of 1 ��,20 L4 Signature Print Name ' t`(" Received ci APR 13 2026 T SA�CTIONA ,ISC .O U FO�ng Board of Appeals b * .r Di niawasf Ibb to Rmyft Infoussfign Which can jhj Wn of Ro ke WhIlm j1ggMqa tg avoid sa: e �J �1 c YOUR NAME: O S`��` �R-�AM J (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 w ch 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 Ilne 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) Q an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this 2 it Signature Print Name Received G APR 13 2026 APPLICANVOWNER 7nning Board of Appeals TRANSACTIONAL DISCLOSURE FOd The T n jif thol ' ofinter the vart 91 sown gftcjs and ruiploys Theporn itf thil f rm ij to mAds InfOrmadilit WILkh"gan Out ths Lq_wg grpossiWgnt•r tan"all it i tak whatever action is oecgMyv to avoid saute.YOUR NAME: J DA-Af Ct-�itrws�.r' (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) Tag grievance Building Permit Variance ✓ Trustee Permit Change of Zone Coastal Erosion Approval of flat 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) Q an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this Irw(3 day of MA*4 -,20 u' Signature Print Name bl`�Yl/ C:~4(3(Exzf Town of Southold Received LWRP CONSISTENCY ASSESSMENT FORM APR 13 2026 A. INSTRUCTIONS Zoning Board ,i Appeals 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# LVP0 1 ^ 6-5 The Application has been submitted to(check appropriate response): Town Board © Planning Dept. 9 Building Dept. 0 Board of Trustees 1.. Category of Town of Southold agency action(check appropriate response): {-� (a) Action undertaken directly by Town agency(e.g. capital 1I construction,planning activity,agency regulation,land transaction) (b) Financial assistance(e.g. grant,loan,subsidy) (c) Permit, approval,license,certification: Nature and extent of action: L,L(! &T1o0 T'v Bo tt t6�G- E-FT POP.. A, PERm�T' TW F-� �Fe-PPERAJ- 70 -rtt"E ZprA 0 Cr- Bb&-&D Of MI '+ Location of action: q '*1' OjNG 'D • Op.,t EN*r l� ecepve Site acreage: 2—( . o(5 0 3`t �kcREs APR 2 Present land use: cS t KWE rP.-M c t.. b w Eu.t tj C' Zoning Board of � e Present zoning classification: 9- 4-0 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: \ 0DAW CtbyvL8e2s F-DR ftx(Ki h"m 1✓os�f %SON M,urzPt-a y (b) Mailing address: 515- WIQ&S (c) Telephone number:Area Code( ) i031' 261 4 — 4 24 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 [:] No M Not Applicable C2-oeee, lS No'r t~o-C oN OR- �Pr Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria © Yes 171 No Not Applicable N D r G 1 N+n�� a ryy 1 / m f a i 77,7 0 N oP.T�A as-r Co(2,rl EZ -7 13? N o APR 1:3 2026 Zoning Boara of riu�eai A, �DS7 fAU 1 �� " 5- OK I N*Or F� , 14 2- ow in ..,,,� �4v m+ r, M � r r !J: ► 3� ry u r� - �cT ,�.; � - L4 �w APR 1 3 2026 IGI Zoning Board of iNppeais ,o r � F �-� b�N E Aff g - f #595 - 2 7147MC3'. ampe uyiE- 1ti � i iZ hC1G�P� b�OENce Fod-� Far- r 5. tQ• 2fe TO W 1A OF SOUTHOLD PROPERTY RE ID DER STREET VILLAGE DISTRICT SUB. - LOT -q R E ACREAGE —FOR�,AER fJ'O,;-qr. W j TYPE OF BUILDING 1-- VL, FARM COMM. i IND. CB. 30 MISC. At CM LAND -4PAP TOTAL DATE REMARKS (D s. + 4- 77 AGE BUILDING CONDITION '_ NEW NORMAL BELOW ABOVE Farm Acre Value Per Acre Value L -Z Tillable I ytv L c� Tillable 2 T Tillable 3 Woodland -A, _2 Swampland , brushland House Plot C -3, �z - - - 1 3 � x EF J. — 3 — a 18,1-6.tij 6/11 ; — _ r a a 3 i i 7� Foundation Both M. Bldg= v„ Floor tehsiona_ Basement s ` 1 Extension Interior Finish Ext Walls Extension Fire Place ' Heat Porch Attic Porch Rooms 1st Floor ' � Breezeway Patio Rooms 2nd Floor i a _ �a � 3 Driveway �. f Garage O. B. `� o s