The URL can be used to link to this page

Home My WebLink About#8128-Porchilo ZBA application FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Received SOUTHOLD,N.Y. MAY 0 4.2026 NOTICE OF DISAPPROVAL Zoning Board of Appeals DATE: March 16, 2026 TO: Cheryl Prochilo PO BOX 698 Mattituck,NY, 11952 Please take notice that your application dated January 21, 2026: For permit to legalize an"as built-addition to an existin ar a at: Location of property: 4714 Peconic Bay Blvd..,C`utcho Yue.NY County Tax Map No. 1000—Section 128 Block 4 Lot 16.1 Is returned herewith and disapproved on the following grounds: The "as built"gzarage addition on this 15.262 s . ft. lot in the R-40 District.is not ernzitted r�rsuant to Article XXIII Section 280-122A which states nothing in this article shall be deemed to prevent the alteration or enter ement of a nonconfornnin buildina containing a conform � t�se. rovided that such action does not create an new nonconforrnance or increase the de ree of nonconformance with re-yard to the re ulations vertaininia to such buildings. The"'as built"garage addition increases the degree of the side yard nonconformance. AutlTzed 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 AP&Mived AREA VARIANCE House No. Street Peconic Blvd Ha Laurel MAY 04 an 4714 Hamlet SCTM 1000 Section: 128 Block: 4 Lot(s) 16.1 Lot Size: .35 Zoning Appeals I(WE)APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED 03/16/2026 BASED ON SURVEY/SITE PLAN DATED 01/21/2026 Owner(s): Cheryl Prochilo Mailing Address: 4714 Peconic Blvd Laurel NY Telephone.516-946-4697 Fax: Email: cheryl.prochilo@gmail.com 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: AMP Architecture for(yf Owner( ) Other: Address: PO Box 152, Mattituck, N.Y. 11952 Telephone: 631-603-9092 Fax: Email: bepperson@amparchitect.com Please check to specify who you wish correspondence to be mailed to,from the above names: (A Applicant/Owner(s), ( )Authorized Representative, ( )Other Name/Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN DATED 01/21/2026 and DENIED AN APPLICATION DATED 01/21/2026 FOR: (Building Permit ( )Certificate of Occupancy ( )Pre-Certificate of Occupancy ( )Change of Use ( )Permit for As-Built Construction ( )Other: Provision of the Zoning Ordinance Appealed. (Indicate Article,Section,Subsection of Zoning Ordinance by numbers.Do not quote the code.) Article:XXIII Section: 280 Subsection: 122A Type of Appeal. An Appeal is made for: (\,f A Variance to the Zoning Code or Zoning Map. ( )A Variance due to lack of access required by New York Town Law-Section 280-A. ( )Interpretation of the Town Code,Article Section ( )Request for Reversal or Overturn the Zoning Officer's Denial Other A prior appeal( )has, C4 has not been made at any time with re§ggSt to this prol2erty 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 Receive REASONS FOR APPEAL MAY 0 4 2026 (Please be specific,additional sheets may be used with preparer's signature notarized): 1.An undesirable change will not be produced in the CHARACTER of the neighbor or2Dpuli3KnWl f'-' of Appeals nearby properties if granted,because: The garage is a conforming use within this district.The property is well shielded from view due to landscaping, it also sits off of the public road. 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: The work is As-built and has already been constructed.Variance will be needed for legalization of existing Garage 3. The amount of relief requested is not substantial because: The Asbuilt garage has already been constructed.The request would not substantially change the area 4.The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: The As-built garage does not and will not have an adverse effect or impact on the physical or enviromental conditions, the community in this area are well developed.The garage with as-built areas remains under the allowable lot coverage„ 5. Has the alleged difficulty been self created? { } Yes,or {V No Why: As-built additions were constructed to an existing non-conforming side yard • Are there any Covenants or Restrictions concerning this land? {\�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. Signd e of Applicant or Authorized Agent (Agent must submit written Authorization from Owner) Sworn to before me this day MARIA PRIKAS cANLEY l Notary Public-State of New York Of \ ,20 2'6 NO.01PR5003206 - Qualified in Suffolk County My Commission Expires Oct 19,2026 Notary Public Z Received Zoning Board of Appeals APPLICANT'S PROJECT DESCRIPTION MAY 0 4 2026 APPLICANT: Cheryl Prochilo SCTM No. 1000-128-4-1 ningBoard of Appeals 1. For Demolition of Existing Building Areas Please describe areas being removed: i w.11ir t th xist. II.New Construction Areas(New Dwelling or New Additions/Extensions): Dimensions of first floor extension: 36-0"x 12'-0"x 10'-6"x 4'-0"x 24'-6" x 16'-0" Dimensions of new second floor: N/A Dimensions of floor above second level: N/A Height(from existing natural grade): 13'-2" Is basement or lowest floor area being constructed?If yes, please provide height(above ground)measured from natural existing grade to first floor: N/A 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: 1 story Garage Number of Floors and Changes WITH Alterations: 1 story Garage IV. Calculations of building areas and lot coverage,sky plane(From Surveyor,Design Professional): Existing square footage of buildings on your property: 2,443 S.F. Proposed increase of building coverage: 2,714 S.F. of permitted dwelling additions; no additions to garage proposed Square footage of your lot: 15,262 S.F, Percentage of coverage of your lot by building area(lot coverage) 16.0%existing; 17.8%proposed 'Gross Floor Area(GF A)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): 1,919 S.F.dwellig only, no habitable space within garage built or proposed For Residential lots, is project within the allowable Sky Plane?(Please refer to Chapter 280, Section 280-208 of the Town Code): yes V. Purpose of New Construction: Legalize As-Built addition to an existing garage 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: Flat land, little to no slope 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. Rein@3 QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION MAY 0 4 Z026 A. Is the subject premises currently listed on the real estate market for saenin� Board of appeals Yes V No o 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? little to no slope 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? Yes If yes, please submit a copy of your building permit and survey as approved by the Building Department and please describe scope of work: Permitted additions to existing single family dwelling 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? No 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 existing single family home with garage,same with detached garage J. (examples:existing single family,proposed:same with garage,pool or other) Zvi Al,lthoriz6fsignature Date i Action is not located near wtlands i of soot, TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, NY RecOved BUILDING PERM IT MAY o 4 202� (THIS PERMIT MUST BE KEPT ON THE PREMISES zoning WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 52760 Date: 03/16/2026 Permission is hereby granted to; Cheryl Prochilo PO BOX 698 Mattituck, NY 11952 To: Construct a one-story addition and alterations to an existing single-family dwelling as applied forto include the removal of roof overto outdoor shower, roof over of existing patio and wood deck. Premises Located at: 4714 Great Peconic Bay Blvd, Laurel, NY 11948 SCTM# 128:4-16.1 Pursuant to application dated 01/14/2026 and approved by the Building Inspector. To expire on 03/15/2028. Contractors: Required Inspections: Fees: Single Family Dwelling- Addition&Alteration $422.00 DEMOLITION $242.00 CO Single Family Dwelling-Addition/Alteration $100.00 Total $764.00 Building Inspector FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Received Southold, N.Y. MAY 0 4 Z020 BUILDING PERMIT Zoning Board of Appeal-S (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 33185 Z Date JUNE 28 , 2007 Permission is hereby granted to: CHERYL PROCHILO 2539 WASHINGTON AVE OCEANSIDE,NY 11572 for CONSTRUCTION OF A ONE STORY ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP 4 25209 at premises located at 4714 GREAT PECONIC BAY BLVD LAUREL County Tax Map No. 473889 Section 128 Block 0004 Lot No. 016 . 001 pursuant to application dated JUNE 20, 2007 and approved by the Building Inspector to expire on DECEMBER 28, 2008 . Fee $ 150 . 00 hor nature ORIGINAL Rev. 5/8/02 AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS Received TOWN OF SOUTHOLD nnAAAAYY nn WHEN TO USE THIS FORM: This form must be completed by the applicant for any spect7#7'lis�'4026 permit,site plan approval„use variance,area variance or subdivision approval on property within Appeals an agricultural district OR within 500 feet of a farm operation located in air agricutta� tM r °t 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:Cheryl Prochilo 2. Address of Applicant:4714 Peconic Blvd Laurel NY 3. Name of Land Owner(if other than Applicant): 4. Address of Land Owner:4714 Peconic Blvd Laurel NY 5. Description of Proposed Project:Legalize As- Built addition to an existing garage 6. Location of Property: (Road and Tax map Number)Peconic Blvd and 1000-128-3-13 7. Is the parcel within 500 feet of a farm operation? { ) Yes {V/ No 8. Is this parcel actively farmed? { } Yes {V�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 I. 2. 3. 4. 5. 6. (Please use the back of this page if there are additional property owners) ._ Signature o pplicant Date Note: 1. The local Board will solicit comments from the owners of land identified above in order to consider the effect of the proposed action on their farm operation. Solicitations will be made by supplying a copy of this statement. 2. Comments returned to the local Board will be taken into consideration as part as the overall review of this application. 3. Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above. The cost for mailing shall be paid by the Applicant at the time the application is submitted for review. 617.20 Appendix B ece��' Short Environmental Assessment Form Instructions for Completin MAY 0 4 2026 Roard of Appeals Part 1 -Project Information. The applicant or project sponsor is responsible for the completion7WA?Q I: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 I -Project and Sponsor Information Name of Action or Project: Prochilo Garage Project Location(describe,and attach a location map): 4174 Peconic Bay Blvd Laurel NY 11948 Brief Description of Proposed Action: Legalize As- Built addition to an existing garage Name of Applicant or Sponsor: Telephone: 631-603-9092 AMP Architecture E-Mail: bepperson@amparchitect.com Address: PO Box 152 City/PO: State: Zip Code„ Mattituck NY 11952 1. Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes, list agency(s)name and permit or approval: T. _.'Total acreage of the site of the proposed action? 35 acres b.Total acreage to be physically disturbed? .0062 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 35 -acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑ Urban ❑Rural(non-agriculture) ❑ Industrial ❑Commercial VResidential(suburban) ❑Forest ❑ Agriculture ❑Aquatic ❑Other(specify). ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? 6. Is the proposed action consistent with the predominant character of the existing l�yl�t,�orw* NO YES landscape? ,,��11 V/ 7. Is the site of the proposed action located in,or does it adjoin,a state listed,0 � 1ijl�lrrJlrtt� ea. NO YES If Yes,identify: LL 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ` / ...... ............ �.. V 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water:...................... ...................... _ / 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ` / 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? `/ b.Is the proposed action located in an archeological sensitive area? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 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 V 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? YNO ❑YES v b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO 9 YES Gutters at roof will be connected to Drywells Page 2 of 4 7 18.Does the proposed action include construction or other activities that result in the irnqp1Jr, nt of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: 00ceNOCI ` / V 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? Zoning 30acd of APPe 80 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: ....m.m................. I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: AMP Architecture Date: 1 'Z(' Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available ever conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 Pr,0,JN/E) No,or Moderate small to large 4 �Oq@ impact impact MA ® Gl1 may may occur occur 10. Will the proposed action result in an increase in the potential for erosioffdN"n0,60&mage 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 Rer,eived MAY 0 4 Z026 Board of Zoning Avvealls Agglication zoning Board of ApPeals AUTHORIZATION (Where the Applicant is not the Owner) I, Cheryl Prochilo residing at 4714 Peconic Bay Blvd Laurel (Print property owner's name) (Mailing Address) do hereby authorize (Agent) AMP Architecture to apply for variance(s)on my behalf from the Southold Zoning Board of Appeals. (O er's Signature) he / P/Vn�//Z) (Print wner''s Name) APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM Rived The Town of Southold's Code or Ethics prohibits c nflicts of interest on theI Part of town:officers and em&_Ies. C ur ose of this form istogrg cN-Inrmation w w hich can alert the ton of Possible conflicts of interest -1 allow it to take a t*o necessary to avoid same. 0 MAY YOUR NAME : Prochilo, Cheryl (Last name,first name,middle initial,unless you are applying in the name of someone else or-Jbnwl�p., ApPealS company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION:(Check all that apply) Tax grievance Building Permit Variance X 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 X 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 t ' Aday oi 211 c* yl Signature xu '-- Print Name Iker " V Received AGENT/RE PRESENTATIVE MAY 0 4 2026 TRANSACTIONAL DISCLOSURE FORM The Town or squthoid,s!Cp_dt of Ethics prohibits conflicts of inttrSj,t on the.Mrt of town this form is to pMide information which can alert the town of possible conflicts of interest and allow it to take whatever active il is necessary to avoid same. YOUR NAME : AMP Architecture (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION:(Check all that apply) Tax grievance Building Permit Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest"means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If 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 day o 201(Q— Signature Print Name_A311�vcr Ation is not located near wtlands ,g Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS Received I. All applicants for permits* including Town of Southold agencies, shall c ylet #h SR-CAF for proposed actions that are subject to the Town of Southold Waterfront C nsiste R view Law, This assessment is intended to supplement other information used by a l � Lath ld, fi y 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# 128 _4 _16.1 The Application has been submitted to(check appropriate response): Town Board 0 Planning Dept. E Building Dept. V Board of Trustees 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) (b) Financial assistance(e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Legalize as-built addition to existing Garage Location of action:4714 Peconic Bay Blvd Laurel Received Site acreage.v35 MAY o 4 2026 Present land use: R-40 Zoning Board of Appeals Present zoning classification:R-40 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address:4714 Peconic Bay Blvd (c) Telephone number:Area Code( ) (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ❑ No® If yes, which state or federal agency`: DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ❑ Not Applicable Yes F] No 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 11 No ❑ Not Applicable A M P Arch itectu re 1 °,5 Address:300 Private Rd F4IL'LGRY 119,52 Phone:631-5 2-5202 0 6 Design + Build x I I r 1 Jr ref% N i t � North of property looking South South West of property(Under patio roof) looking North East III 'VV e North West looking South West of property looking East �l I r t moil dew �u South of property looking North North East of property looking South West Prochilo Garage-4714 Peconic Bay Blvd Laurel NY 11948 Owner:Cheryl Prochilo Applicant:AMP Architecture All Photos taken on August 5ch 2025 "'OLOR E € 1 3 E 3 TRIM is l - I E i _ 128.-4-16.1 2/08 E — M. Bldg. Foundation 1 - 'Both t`F/ Dinette Extension , Cm rserne j Floors = K. x . 'l �� 6 xYentio ;l 1 l0 k33 d� �' Z'r—U 112 a xt, Walls a. Intern F'n sl w LR. �nsion [ Q) ` Fire PlaceS�o Heat , °� j � d DR. �_� s" a Roof Roomi ist Floor - BR. ` `. 3 - ?Recreation Room Rooms 2nd Floor FIN. B, .,,. I Porch 5y- ,G DormerP �" Y 4160I ay Driveway Garage j 2-0 Patio .,._` 'a IZ X L5 L6C) 500 1 L6 q575 O. B. 05o qq Toto I - - TOWN OF SOUTHOLD PROPERTY RECORC Ml - OWNER STREET VILLAGE DIST. SUB. LOT FORMER OWNER N E ACR. S I W TYPE OF BUILDING D SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL 0 DATE REMARKS p- a XJ C=D /j� r A cc 0 N AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tmoble 1 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON-ROAD House Plot DEPTH BULKHEAD Total iDOCK 1 i rd € v M. Bldg. (Foundation Both Dinette Extension I Basement Floors K. i Extension Ext. Walls Interior Finish LR. i I F--nsion Fire Place Heat DR. Type Roof Rooms 1st Floor BR. Porch Recreation Room Rooms 2nd Floor FIN. B. Porch Dormer Breezeway lDrivewoy Garage i Patio I O. B. Total ,e