The URL can be used to link to this page

Home My WebLink About#8136-Parisi ZBA application FORM NO. 3 01 TOWN OF SOUTHOLD Received BUILDING DEPARTMENT SOUTHOLD,N.Y. MAY 2 2 2026 NOTICE OF DISAPPROVAL Zoning Board of Appear Date: February 6, 2026 RENEWED: May 21,2026 TO: Michael Parisi 145-54 6th Ave Whitestone,NY, 11357 Please take notice that your application received March 27, 2025: For permit to: demolish and construct a sinyle-family dwelling at: Location of property: 1840 Delmar Drive Laurel NY County Tax Map No. 1000— Section 127 Block 4 Lot 19 Is returned herewith and disapproved on the following grounds: The proposed construction on this non-conforming 21,964 s . ft. parcel in the Residential R-40 District is not pe-muted u.rsuant Article XXIII 280-124 which states lots rneasuring between 20,000 and 39 999 s ure feet in total size require a minimum front yard setback of 40 feet. The foundation location shown on the site vlan shows the construction to have a front yard setback of 32.7 feet. *NOD is in conjunction with building permit# 51893 1 o_< A . cried. 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 BOAM,OF APPE ceived AREA VARIANCE House No. hio Street V E(.f"Af- QRZ 1JE Hamlet L-AOREL- MAY 212026 SCTM 1000 Section: 2, Block: 4' Lot(s) l C7 Lot Size: 0,6* 4 Apppaa,s I(WE)APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED gARC 27 4 2SBASED ON SURVEY/SITE PLAN DATED h U6, • $ 2,0 2S Owner(s): 'PAU W t C 1A-A eL- F A R L-7 1 Mailing Address: 14 S 54 6i 1�1 AV e + Ktn--5-Tb"F— Telephone: Fax: Email: 6fi5i 100IV JYVaO •Cbrn NOTE:In addition Lb 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: J 6) N C k-k-A rA8 C"93 for()�Owner( ) Other: Address: P- n- 80x 4 S D U Tl-tow . '*-{ . (03 -2ct4 4241 vi ��e, <s t o P tnu a,corn. Telephone: Fag: Email: oa Please check to spedafy who you wish correspondence to be mailed to,from the above names: ( )Applicant/Owner(s), CoofAuthorized Representative, ( ) Other Name/Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE P WDA"IED 0( "'2- 2( and DEFIED AN APPLICATION DATED O 32SFOR: uilding Permit PE2mA r tf 5189 3 ( ) 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 q uote the code. Article: X(I( Section: Zgt7 Subsection- 12-4 Type of Appeal. An Appeal is made for: PO 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, has not been made at an time with res ect to this ro e 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 SEA Oki-jWC 1A M eNS"( 1�0/ Revised 6/2023 received REASONS FOR APPEAL (Please be specific,additional sheets may be used with preparer's signature notarized): MAY %% Mb 1.An undesirable change will not be produced in the CHARACTER of the neighbor or a detriment Of Appeals nearby properties if granted,because: Zoning Boar 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? { } Yes, or { }No Why: • Are there any Covenants or Restrictions concerning this land? {d No { }Yes(please furnish a copy) 0 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 Applica or Authorized Agent (Agent must submit wr tten Authorization from Owner) Sworn to before me this ' 7yn day CONNIE D.BUNCH Notary Public,State of New York of MCL�- fl_ No.01 BU6185050 Qualified in Suffolk County Commission Expires April 14,2 Q� Notary Public fiecelVed 1. An undesirable change will not be produced in the character of the MA_ or a detriment to nearby properties if granted, because: Y Based on Zoning Code 280-104 which reads in part that ° the front yard s aN Wea►s the average setback of the existing buildings within 300 feet of the proposeuildiag on the same side of the street within the same use district.", the Building Dept issued permit #51893 for the house. The one and a half story house and proposed covered entry porch are architecturally in keeping with other homes in the neighborhood. 2. The benefit sought by the applicant cannot be achieved by some other method feasible for the applicant to pursue, other than the area variance because: The house was designed to accommodate an entry porch that is 22'-8" wide and 6'-0" deep and it is proportionally correct for the front elevation of the house. The house, under permit# 51893 is mostly built, and an alteration of the facade at this point is a difficulty. 3. The amount of relief requested is not substantial because: Section 280-104 C.2.allows for a front porch to extend 5'-0" into the front yard as an exception to the yard requirements and this proposed porch on this property projects 6'-0". 4. The variance will not have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: The physical or environmental conditions of the structure have been reviewed and approved during the permit process. 5. Has alleged difficulty been self created? The difficulty was created by an error in the layout by the masonry contractor. n i :)�� rd of Appeals Zoning,Board PP APPLICANT'S PROJECT DESCRIPTION ��1� OJ r(\%,Ct*Ae_ 0 'PANL-1t � No o APPLICANT.. 0Ato � ' SCTM No. 1.For Demolition of Existing Building Areas Zon�n9 Please describe areas being removed: U.New Construction Areas(New Dwelling or New Additions/Extensions): Dimensions of first floor extension: '►A Ap,cAk °2 Dimensions of new second floor: MIA Dimensions of floor above second level: Height(from existing natural grade): f Is basement or lowest floor area being constructs if yes,please provide height(above ground)measured from natural existing grade to first floor. MIA III.Proposed Construction Description(Alterations or Structural Changes) (Attach extra sheet if necessary).Please describe building areas: r Number of Floors and General Characteristics BEFORE Alterations: �0 10X ar.c.o' Number of Floors and Changes WITH Alterations: r F(odr IV.Calculations of building areas and lot coverage,sky plane(From Surveyo Design Professional): Existing square footage of buildings on your property: 4 e A.V& ?(o S.F. Proposed increase of building coverage: "f" + d"' Square footage of your lot: percentage of coverage of your lot 6y building area(lot coverage) 14. 8 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): For Residential lots,is project within the allowable S Plane?(Please refer to Chapter 280,Section 2W208 of the Town Code): rp ion: , . +oca Construction: . V.Purpose of New Const o VL 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: 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. Revisal 6/2023 QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION FWCOVed A. Is the subject premises currently listed on the real estate market for sale? �AY 2 2 Zp26 Yes X No B. Are there any proposals to change or alter land contours? Zoning No Yes,please explain on separate sheet. C. 1.)Are there areas that contain sand or wetland grasses? ZSfo 2.)Are those areas shown on the survey submitted with this application? 3.)Is the property bulk headed between the wetlands area and the upland building area? .)If your property contains wetlands or pond aremi have you contacted the Office of the BOARD QE M&T—EE5for its dctrrmination of juirisdiction? Please confirm status of your inquiry or application with the Board of Trustees: T If issued,please attach copies Iof 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? Afo_ 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? 'CJ' If yes,please submit a copy of your building permit and survey as approved by the Building Department and please describe ape f work: 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? 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 1. Codnplee existing single f i ,proposed.same wit(garage,pool or other) s,S' Authorized signature Date FORM NO. 4 TOWN OF SOUTHOLD, BUILDING DEPARTMENT �173 Town Clerk's Office Southold, N. Y. �iec&►ed MAC %% zo Certificate Of Occupancy Zonjng guard °§ J%Ppeats No. 2 2. . . , . Date . . . . . . , , J:=G. . 29. , . . . . . ., 19.73. THIS CERTIFIES t4at the build14 located at De r..prAVo. . . . . . . . . . . . . Street Map No. .0 I. tyB� No. . . . . . . . . . .Lot No. N.ly Y• 1 . . . . . . . . . . conforms substantially-to the Application for Building Permit heretofore filed in this office i dated . . . . . . .. . . . MAR, Z$ , ., pursuant to whit h Building Permit No,641 Z . . dated . . . . . . . . . .NAr. . . 28 , . ., 19 73 was issued, and conforms to all of the require- ments of th,e. applicable provisions of the law. The occupancy for which this certificate is issued is . #A*a,te . one Xamily. d*e11 g . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate.is"issued to Barry.ra0de. & .Wife. . . . p iex+a . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid 'building. Suffolk County Department of I3elth Approval .JVe : 7$. .t 97 . . . ►y. its .Villa. . . . UNDERWRITERS CERTIFICATE N*. .i.oina . . . , „ . . . . . HOUSE NUMBER. . .484fl. . . . . .StredIt. . . Delmar. -Dri to . . . . .. . . . . . . . . . . . » . . u . . . . . . . » . . . . . . . . . . . . . . . . . . . . . . . .. . ». Building Inspector LAI ao a FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. viecelved CERTIFICATE OF OCCUPANCY ONI S S No Z17221 Date AUGUST 23, 1 Agim THIS CERTIFIES that the building ACCESSORY Location of Property 1840 DELMAR E? IVE LAUREL House No. Street Hamlet County Tax Map No. 1000 Section 127 Block 4 Lot 1 Subdivision LAUREL COUNTRY EST.Filed Map No. 5486 Lot No. 47 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 26 1987 ursuant to which Building Permit No. 16395Z dated AUGUST 30 1987 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 ACCESSORY GARAGE. The certificate is issued to DOUGLAS G. & NANCY M. HAVILAND (owner, xxxxxxXXXXxxxxxx) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N A UNDERWRITERS CERTIFICATE NO. H003837 PLUMBERS CERTIFICATION DATED N A �'�• B din� . g Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT m Office of the Building Inspector Town HallT Southold, N.Y. CERTIFICATE OF OCCUPANCY 006 0 No: Z-27925 Date: 09 10 01 THIS CERTIFIES that the building ALTERATIONS Location of Property: 1840 DELMAR DR LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 127 Block 4 Lot 19 Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUKE 15, 2000 pursuant to which Building Permit No. 26709-Z dated AUGUST 8 2000 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 ALTER GARAGE TO LIVING SPACE ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to LAWRENCE & DEBORAH CONNER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NLA ELECTRICAL CERTIFICATE NO. PENDING 08 13 01 PLUMBERS CERTIFICATION DATED N A on d Si Lure Rev.' 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector �tecewe Town Hall Southold, N.Y. SAY 2ti �020 CERTIFICATE OF OCCUPANCY 7-0609 Board °f P�Ppeals No: Z-29586 Date: 07/23/03 THIS CERTIFIES that the building FIRE REPAIR Location of Property: 1840 DELMAR DR LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 127 Block 4 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 8, 2003 pursuant to which Building Permit No. 29115-Z dated JANUARY 17, 2003 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 FIRE REPAIR ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR, The certificate is issued to LAWRENCE & DEBORAH CONNER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL _ N/A_ ELECTRICAL CERTIFICATE NO. 1101681 05/23 03 PLUMBERS CERTIFICATION DATED - N/A x Au prized Signature Rev. 1/81 of Town of Southold P.O. Box 1179 53095 Main Rd U Southold, New York 11971 ece, ed CERTIFICATE OF OCCUPANCY MAY %% Zo No: 46067 Date:Zd"W)MI of Appeals THIS CERTIFIES that the building ELECTRICAL-RESIDENTIAL Location of Property: 1840 Delmar Dr Laurel NY 11948 S ec/B lock/Lot: 127.-4-19 Conforms substantially to the Application for Building Permit heretofore,filed in this office dated: 03/18/2025 Pursuant to which Building Permit No. 51757 and dated: 03/18/2025 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: 200 amp overhead temporary service The certificate is issued to: Michael Parisi Paula Parisi Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 51757 3/26/2025 PLUMBERS CERTIFICATION: Authorized Signature TOWN OF SOUTHOLD " BUILDING DEPARTMENT $'( � TOWN CLERK'S OFFICE 1�gd SOUTHOLD, NYOe gay �ti�02° 6°ard PPPea1s BUILDING PERMIT °{ 70 1ng (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: S1893 Date:OS/02/202S Permission is hereby granted to: Michael Parisi 14S-S4 6th Ave Wnitestone, NY 3.1337 To: Demolish an existing single-family dwelling and construct a new single-family dwelling as applied for per SCHD approval. Premises Located at: 1840 Delmar Dr,Laurel, NY 11948 SCTM# 127.4-19 Pursuant to application dated 03/27/2025 and approved by the Building Inspector. i o expire on ub1uz/zuz r. Contractors: Required Inspections: Ems• DEMOLITION $698.00 Single Family Dwelling-NEW $3,250.00 CO Single Family Dwelling-New $100.00 Total 94,048.00 � �Building Inspector �� TOWN OF SOUTHOLD—BUILDING DEPARTMENT' Jed Town Hall Annex 54375 Main Road P. 0.Box 1179 Southold,NY 1197 1 Telephone(631)765-1802 Fax(631)765-9502 htt ;// orr �02� :x ti2 � fieceld of APPLICATION FOR BUILDING PERMIT7o�iti �o� E For Office Use Only PERMIT NO. Building Inspector~ MAR 2 Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant Is not the owner,an Stull Ing Department. rn me. A�Rhorlr n;fArm I R, l.shall he, rr�pk+t l.. :.. -:. ., Town of + th Mtlr Date:, v z�-1 R Co. OWNER(S)OF PROPERTY: Name: 'ekSCTM#1000- )A / - q-- I Project Address: Phone#: Email: PAT, SiA , Mailing Address: ky 5 . 54 01• aJ :erSAA1 Dr N ? 113 S CONTACT,PERSON: Name: m`I +of 1 C;l C' 15 O Y Mailing Address: �L45 - 54 Phone#: ,-I Email: �H �~ 'r 1 r 9 c1 r+S 4 �b CL1 p I. t o Irr� DESIGN PROFESSIONAL INFORMATION: Name: oey L 2 RA�Hinn Arielrocc• e""O' i i ,<` . .w .� .,• +► 1, � ; na g r�uu �.au. *^"7 V 10 434 ir`1 •�. V G Ij IV ;1 1 Phone#: y `1 I Email 3 .� 5 � 1 CONTRACTOR INFORMATION: Name: o - A M Mailing Address: Phone#: �o _ 1 y Email: , \r'ejo tau .«c DESCRIPTION OF PROPOSED CONSTRU "ION, MNew Structure ❑Addition ❑Alteration ❑Repair WDemolition Estimated Cost of Project: ❑Other ,O p oe Will the lot be re-graded? ❑Yes PNo Will excess fill be removed from premises? PYes ❑No 1 PROPERTY INFORMATION Existing use of property: Intended use of property: Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes❑No IF YES, PROVIDE A d Check Box After Reading: The ow.w/contractw/desllpi professional is mponsible for all drainage and stormWM=as provided chapter 236 of the Town Code APPLICATION is HEREBY MADE to the Building Department fw the issuance of a Buldim flit pre s mo OrhRnacnce of the Town of Soud%oK Suffolk,County,New York and other applicable taws,Ordinances or Repletion,for the hrys additions,alt9roMm or for removal or de.. Utbn as herein described.The applicant agrees to comply with al applicable laws,ordinances,bu'ildit housing code and regulatkms and to admit authorized inspectors on premises and in bulldingls)for necessary Inspections.Nihnt statements punishable as a Class A mtsderneanor pursuant to Section 210AS of the New York State Penal law. Application Submitted By(print na ): (�S r�/(> [31(uthorized Agent Owner Signature of Applicant: Date: ROBSRTO VIOLA Notary Public, State of New York STATE OF NEW YORK) No,01VIS189600 S Certified in Queens County COUNTY OF Oinrnisslon Expires 06/30/20n Is 101-) - A t S-e J being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (She is the (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. Sworn before rn this V\ day of 20 Notary ublic I%JA PROPERTY OWNER AUTHORIZATION i r (Where the applicant is not the owner) ,ems I, M iC ir` residing at ) 7U Ue I r.ck r � Lout %IN q � f o hereby authorize Al 0 )-re dT Ir 3 - A rrwp a to apply on my behalf to t Town of Southold Building Department for approval as described herein. DI 17 2r Owner's Signature OL ate ROBERTO VI Notary Public,State of New York 19"" A No.OIVIS189600 Print Owner's Name Certified In Queens County J� Commission Expires 06/30/20� Q 2 t AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS ?k7l TOWN OF SOI]TIIOLD WHEN TO USE THIS FORM: This form must be completed by the applicant fur any sped permit,site plan approval, use variance,area variance or subdivision approval"on p ivl an agricultural district OR within 500 feet of a farm operation located in an agricultural district, ea; All applications requiring an agricultural data statement must he referred to the, urffal%g$,j Pp Department of Planning in accordance with Section 239m and. 39n of the GengQfAnivipal Law. 1. Name of Applicant; Jokfj 01;� �,p 2. Address of Applicant: PO o 8 bib N a -1 3. Name of Land Owner(if other than Applicant): vk.k 4 M W gftL k-6 4. Address of Land Owner: 1 45 —574 'Cl,'� AVE l t 3 5'7 5. Description of Proposed Project: W SLM&LF, fr/�y�llt, l6a�NGE ( p �h Da t ue tt t�ReL N Y 6. Location of Property: Road and Tax ma Number) D 1 000- 1'L7- 4 - I 7. Is the parcel within 500 feet of a farm operation? {of Yes { }No 8. Is this parcel actively farmed? {of Yes ( ) 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. RAL,,F fA LLo0 hJvfk E RE--tj CbR . 6ZA- Pgp& PA! + 2. (ow- n-,— 3 — 12 Dly H-LL"S NJ I1-46 3. 4. 5. 6. (Please use the back of this page if there are additional property owners) A- / 2 S Signature of Applicant Date Note: 1. The local Board will solicit comments fi•om the owners of land identified above in order to consider the effect of the proposed action on their farm operation. Solicitations will be made by supplying a copy of this statement. 2. Comments returned to the local Board will be taken into consideration as part as the overall review of this application. 3. Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above. The cost for mailing shall be paid by the Applicant at the time the application is submitted for review. 617.20 Appendix B Short Environmental Assessment Form vwceW ed Instructions for CompletingMpY 2 ti 2020 Part 1-Project Information.. The applicant or project sponsor is responsible for the completi n t 'pon es become part of the application for approval or funding,are subject to public review,and may be su V wither 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 IPA-Kul RIEcSIDEOCIG Name of Action or Project: S`-b D EL-MA-R, D R v E 1 l,/tv CZ.�� N 4 Project Location(describe,and attach a location map): Brief Description of Proposed Action: COVe2eo e-nlTt_J (>d2C#v& oP S1INI&lrE eA-MtL.J YZ4EF10e^JC'e . Name of Applicant or Sponsor: Telephone: 31 2-4 J D Gtt7M Q e(ZS E-Mail: �n cha r .r Sl 'l Ca n Address: To BN< 4� City/PO: State: Zip Code: SOU Tg0L49 0� t l 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 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: S0UT1+0L_0 $t-06 • Fe(ZmtT X 3.a.Total acreage of the site of the proposed action? b.Total acreage to be physically disturbed? a c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? a. -Dacres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban YRural(non-agriculture) ❑Industrial ❑Commercial Residential(suburban) ❑Forest gAgriculture ❑Aquatic ❑ Other(specify): ❑Parkland Page 1 of 4 V 31� 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? �� + n Slr TB � � "" � b.Consistent with the adopted comprehensive plan? 6. Is the proposed action consistent with the predominant character of the existing built or nat NI 2 c 'ZQ� NO YES landscape? �Q 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmept�J rrca. NO YES If Yes,identify: 1� m9 i 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. 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 N 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? NQ I 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? I NO❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO RrYES Page 2 of 4 I&Does the proposed action include construction or other activities that result in the impoundrn t NO YES water or other liquids(e,g. i-etcrition,pond,waste lagoon,dam)?If Yes,explain purpose and size: to( V/ V� - 19.Has the site of the proposed action or an adjoining property been the location of an active or NO YES WIM(r ----g I NT solid waste management facility? oard �,qp If Yes,describe: ............. ......... 01 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: Iaerk--J Date: 4- 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 ............ I Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large irct act impact may e0,60 occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainag� c 'Lp26 problems? ON l 11. Will the proposed action create a hazard to environmental resources or human health? a pt APP t7 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 Roard of Zoning Appeals Application 3Jo OWNER'S AUTHORIZATION (Where the Applicant is not the Owner) �026 spy 2 2 70n'N Board of �PP�als 1, M t c t-�` I"5-54 6t70-AV r W R t TE:'M(''V- N Y 113s7 (Print property owner's name) (Mailing Address) do hereby authorize O/t 0 C ttlklO 6leV (Agent) to apply for variance(s)on my behalf from the Southold Zoning Board of Appeals. By signing this 4ecumeut,the-Property Owner understands that pursuant to Chapter 280- 446(R)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 DFSt.RLBED HEREIN. 0�1 (0ivner,s Signature) (Print Owner's Name) B�"rrd 2 ff&aIng + l Iic don spy ti�2026 WNER' A. H K& ofi �Ppeals (Where the Applicant is not the Owner) Bpard . Zo�in9 md&S at " « 4Tti Iw r '- N (print property owner's name PdailiaS do hereby authorize J o#k rj CktkN�6 ' (Agent) L to apply for vanance(s).onmy behalf from the. Southold Zoning Board of Appeals. Ay siguigg-this document the prmpaerty Owner onderstands4hatImrsuant to Chapter 2W 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. TT i' T EBQM31 QWqER!fiBit "PNSM=TOMME MMMANQ VATR. aA, Pa631 (Print Owner's Nate r m AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM � u IlicTo wn Itf 52gtholdI GodSl t n i fin µr t 2n the part of t2gg qfkjEs ggl gWolgrA,Thg f � , this owide informationwhich f s l nfl is o to est nd allow it o take h to gvoid satne YOUR NAME: b kN C"-Awt�3�R-s' 7nlp goatd o� A�Peais (Last name,first name,middle initial,unless you are applying in the name of someone else or other entify,such as a company.H so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance ✓ Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest"means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee. Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this VK day of P21L 20 Signature Print Name geceWe APPLICANT/OWNER- TRANSACTIONAL DISCLOSURE FORM spy 2 2 �026 Tfig TgwLro gf§outbold's Cgds gf EthlEj grobibitsconflicts of i Lat—errit go The part this f rM Is to lj!avA1jjnfgrmation which can,aleat 09 ISM ofilossiblel f int M t an a—]I=it:Lq t e r ac" n is Ilegessaa o&Uld 11me, YOUR NAME: Nt ICZ- ��R 1rS' 1 __ ... . ........... ¢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 Mooting 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.hich,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 stuck 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 2 s - day of *(t ,20 Signature �XQ'- Print Name �l APPLICANTIOWNER spy 2 2 TRANSACTIONAL DISC LOSURE FORM ANI Boar of ApPea s a YOURNAME: 6L full _.. (taunt nems,ffist naase,astd c alai eel eq yao are apples,bw t9wa ause of dawn or ore aNtk, 1 a eompany.lrm,.to data the o6er person's or compasy's eeme.) TYPE OF APPLICATION:(Check all that apply) Taz grievance Building Permit Variance Trustee Permit Change of Zane Can"Erosion Approval of Plat � Mooring Other(A ) Planotng Ito you,personalty(or through your company,sponse,sibling,parent,or )have a relationship with any air or employee of the Town of Southold?41tviations,hip"Includes by blood,marrlagc or business interest,"Business InorW milm h bulava'In g pofft4nW,In wbi 1 UK�m 9MM 91' 044 i1 phi) ownership of(or employment b )a corporation In whieb the town officer or employee owaa more than S%of the sbares. YES NO Uyou 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(tbe a 'dogent/representative)and the town officer or zosployee. Either check the,appropriate tine A)through'D)and/or describe in the space provided. The town otIIeer or employee or his or her spoese,sibilog,parent,or child is(check all that apply) A)the owner of greaicr that 5%of the shares of the corporate stock of the applicant(when the applicant is sa corporation) _B)the le`ol or bencgcW owner of any Interest Loa nun.corporato entity(when the applhyatts not a corporation) Q an officer,director,partner,or employee of the applicant;or _0)the actual applicant DESCRIPTLON OF RELATIONSHIP Submitted this day of lL 20 Sisuature re Print Name Town of Southold R LWRP CONSISTENCY ASSESSMENT FORM ReCeivec't A. INSTRUCTIONS MAY 2 2 2026 1, All applicants for permits* including Town of Southold agencies, shall completeart�a ,fctr proposed actions that are subject to the Town of Southold Waterfront ConAWfl 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# t i- + I The Application has been submitted to(check appropriate response): Town Board El Planning Dept. 0 Building Dept. El Board of Trustees 0 ZB A q' 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: )k?Ft,lCA'Ttonl -ram A r-Q& VARI A-+CE f-toR. nk0N T- y A-ttD B cI4 'fa F"PD5ip FR-DN 'F oRcif Location of action: U B4b d F-mA-t< D KW E Site acreage: Q• 5 6 4 A CR-ES Receiv Present land use: s(N Cr L inn P,es(D ex'm A- - Z026 Present zoningclassification: - '{D �` of Appeals Zoning Dar 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: 'FOLA ?AA—(,St U WNt;RS' (b) Mailing address: l 4S- 54 6"4 yE W tt LTe rates e ry y H 3s7 (c) Telephone number:Area Code( )_ ( - 6 46 8 7 2 " 4'L 2 (d) Application number,if any: Q •P. 0 51 893 Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No Rr If yes,which state or federal agency? DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure,makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III-Policies; Page 2 for evaluation criteria. ®Yes ❑ No Not Applicable T Ct LtQUM04 SO-r lltlff- , fit IV V I N G vV(TK r=� o p 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 D No 1� Not Applicable 'LKIOaE kkC- Na (-t 15'CD2lG O(Z. 't eDL OC6l CW TOWN OF SOUTHOLD PROPERTY RECORD CARD E ET VI LOT D ER O N _ y N E A R. _ 5 - - TYPE OF BUILDING, - x RES. FARM COMM. CO. MIC$ Mkt. Vohas t LAND IMP. TOTAL 11 DATE REMARKS cot e _ s e .' � y i NEVZ7 -cr- kW Acre Value PerValue Acre T4iloblo Woodkind FRONTAGE ON ROAD Moodow1ond DEPTH BULKHEAD. _ TOW %00 w" �• - t _ --- a� I ' E s I I t TRIM { s - ma's: x 14 �Tm E � I! p3 o I g '. 127-4-19 2/04 � i M. Bldg. A E � za k i Extension E Extension Extension i i - Foundation G Bath / Dinette I Porch Basement f,; Floors - I Porch Ext. Walls Interior Finish r _,� LR. Breezewayo�� Fire Place Heat °� -- DR Garage � .- s hype Roof Rooms 1st Floor IBR, r � ;. � rRecreation Room Rooms 2nd Floor FIN. B O. B. l Dormer Driveway ;7(Total r L ate. MR+a' CD t