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HomeMy WebLinkAbout#8139SE-Wilsberg ZBA application Accy Apt Revised 6121123 TOWN OF SOUTHOLD ZONING BOARD OF APPEALS Phone (631) 765-18019 Received APPLICATION FOR A SPECIAL EXCEPTION PERMIT FOR AN ACCESSORY APARTMENT IN AN ACCESSORY BUILDING JUN 0 3 2026 Appeals Applicant(s)Name(s) James ilaber Applicant(s)Address 800 Depot Lane Cutcho ue New York Phone: Email: [xJ I/we are the owners of the subject property [xJ I am the agent for the property owner and my Letter of Authorization and Transactional Disclosure Form is attached. Representative(if other than applicant): William C. G o i n s Address PO Box 65 13235 Main Road Mattituck New York Phone: 631 .298 . 4818 Email: 2.&ginslaw@gmail .com A. Statement of Ownership-and 1 iterest: James W i 1 s b e r g is(are)the owner(s)of the property known and referred to as 800 Depot Lane Cutcho ue New York 11935 House No. Street Hamlet Zip Code Identified on the Suffolk County Tax Maps as District 1000, Section 10 2 Block 2 Lot(s) 6 .5 Lot Size 1 . 8-Lone DistrictR 8 0 as shown on the attached deed and survey The above-described property was acquired by the owner(s)onwu ___ Q, �l_f)__ Uwe hereby apply to the Zoning Board of Appeals for a Special Exception Permit pursuant to Section §280-13B(13) of the Zoning Ordinance to establish an accessory apartment in an accessory building as shown on the attached survey/site plan and floor plan(s) B. Project Description: Accessory apartment ...located i' ac e o r building �w ly m_elnber ..�, July 2023 C Application Page 2,Special Exception for Accessory Apartment „ Received C. The applicant alleges that the approval of this special exception would be in harmony with the intent and purpose of said zoning ordinance, and that the proposed use conforms to the standardUtIs 0 therein and would not be detrimental to roe or persons in the nei hborllood for the followi � 026 reasons: Zoning Board Of Appeal,, There is a bed and breakfast use across the street tothe north; Farm land to the south and east ; and residential use to the north D. The applicant alleges that the following standards prescribed by Section §280- 13(B)(13)(a)-(k)of the zoning ordinance will be met: a. The accessory apartment will be located in the accessory building. b. The owner of the premises shall occupy either the existing single-family dwelling or the accessory apartment in the detached accessory structure as the owners'principal residence. The other dwelling unit shall be occupied by a family member as defined in Section§280-4 of the code or a resident who is currently on Southold Town's Affordable Housing registry and is eligible for placement,evidenced by a written lease,for a term of one or more years. c. The accessory apartment shall contain no less than 220 square feet and does not exceed 750 square feet of livable floor as defined in Section§280-4 of the code d. The accessory apartment will be located on one floor of the accessory building and will contain No more than two bedrooms and No more than one bathroom. e. A minimum of three on-site parking spaces shall be provided as shown on the attached survey. f. Not more than one(1)accessory apartment shall be permitted on this parcel. g. No Bed and Breakfast facilities,as authorized by Section§280-13(B)(14)hereof shall be permitted in or on the premises for which an accessory apartment is authorized or exists. h. The accessory apartment will meet the requirements of a dwelling unit as defined in Section 280-4 of the Zoning Code. L This conversion shall be subject to a building permit,inspection by the Building Inspector and Renewal of Certificate of Occupancy annually. j. The existing accessory building which is converted to permit this accessory apartment has been in existence and has a valid Certificate of Occupancy fdr no less than three years,and is attached hereto. k. The existing building,together with this accessory apartment,shall comply with all other requirements of Chapter§280 of the Town Code of the Town of Southold. 1. This conversion for the accessory apartment shall comply with all other rules and regulations of the New York State Construction Code and other applicable codes. E. The property which is the subject of this application (check all that apply): [X]has not changed since the issuance of the attached Certificates of Occupancys [ ]has changed or received additional building permits. Certificates of Occupancy for these changes are attached or will be furnished [ ]has been the subject of a prior ZBA decision(s), copies are attached wne gnalu �.' re COUNTY OF SUFFOLK) ss.: STATE OF NEW YORK) wor qt Abloirm is day of March 120 26 (Notary Public) WILLIAM C. GOGGINS 6121123 NOTARY PUBLIC-STATE OF NEW YORK No.02GO4963689 Qualified in Suffolk County July 2023 My Commission Expires 03-12-2026 Received QUESTIONNAIRE JUN o 3 2026 FOR FILING WITH YOUR ZBA APPLICATION A. Is the subject premises listed on the real estate market for sale? Zoning Board of Appeals Yes X No B. Are there any proposals to change or alter land contours? __X_No Yes,please explain on attached sheet. C. l.)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? No 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 Trustees: N/A and if issued, please attach copies of permit with conditions and approved survey. D. Is there a depression or sloping elevation near the area of proposed construction at or below five feet above mean sea level? No E. Are there any patios, concrete barriers,bulkheads or fences that exist that are not shown on the survey that you are submitting? No Please show area of the structures on a diagram if any exist or state none on the above line. F. Do you have any construction taking place at this time concerning your premises? No G. If yes,please submit a copy of your building permit and survey as approved by the Building Department and please describe: H. Please attach all pre-certificates of occupancy and certificates of occupancy for the subject premises. If any are lacking, please apply to the Building Department to either obtain them or to obtain an Amended Notice of Disapproval. I. 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. J. Please list present use or operations conducted at this parcel i I o F are R s d l l i a and the proposed use Sing-1 Familv Residential prtmen K. (example: existing single family,proposed: same with garage,pool or other) 3 - v A.Ut r 'ed signature and Date IZ July 2023 Town of Southold Annex 9/17/2012 P.O.Box 1179 n 54375 Main Road Southold,New York 11971 Received Il IN 0-3.2Qa.. CERTIFICATE OF OCCUPANCY Zoning Board of /apG a No: 35957 Date: 9/17/2012 THIS CERTIFIES that the building ACCESSORY Location of Property: 800 Depot Ln, Cutchogue, SCTM#: 473889 Sec/Block/Lot: 102.-2-6.5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 4/23/2012 pursuant to which Building Permit No. 37177 dated 4/27/2012 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: accessMunheatecLnonhabitalbe30'X48'.worksbm.wijtbstorage and attic storage as applied for. The certificate is issued to Gaylor,Paul of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37177 8/23/12 PLUMBERS CERTIFICATION DATED A o Aipatur Town of Southold 4/26/2018 P.O.Bog 1179 53095 Main Rd Southold,New York 11971 I%Wwkwvl CERTIFICATE OF OCCUPANCY JUN 0 3 2026 No: 39617 Date "09 B11*6/201Appeajs THIS CERTIFIES that the building IN GROUND POOL 1 Location of Property: 800 Depot Ln, Cutchogue SCTM#: 473889 Sec/Block/Lot: 102.-2-6.5 Subdivision: Filled Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/28/2017 pursuant to which Building Permit No. 41602 dated 5/3/2017 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 IN-GROUND SWDJMING POOL- FENCED TO CODE AS APPLrED FOR The certificate is issued to Wilsberg,James of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 41602 10/03/2017 PLUMBERS CERTIFICATION DATED 't o Signature FORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Zoning Board Of Appeals CERTIFICATE OF OCCUPANCY No: Z-29807 Date: 10/30/03 THIS CERTIFIES that the building NEW DWELLING Location of Property: 800 DEPOT LA CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 102 Block 2 Lot 6.5 Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 2, 2002 pursuant to which Building Permit No. 28664-Z dated AUGUST 16,_ 2002 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH COVERED FRONT PORCH,_ REAR DECK AND ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to GOLD CREEK BUILDING CO CORP (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-02-0110 0 20/03 ELECTRICAL CERTIFICATE NO. 3179 05/1 /03 PLUMBERS CERTIFICATION DATED 06/24/03 GOLD CREEK BUILDING CO ho zed ignature Rev. 1/81 AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS TOWN OF SOUTHOLD WHEN TO USE THIS FORM: This form must be completed by the applicant for any special use permit,site plan approval, use variance, area variance or subdivision approval on property Itpithin an ggrieultural district OR within 0 Let oLa Larm g&ELation located in an ricultural district All applications requiring an agricultural data statement must be erred to the Suffolk County Department of Planning in accordance with Section 239n=aw 'de SIGeneral Municipal Law. -4/1 JUN 0 3 2026 1, Name of Applicant: ...idgmejs Wil,Qbgrg 2. Address of Applicant: 800 Depot Lane, Cutchogu,e , Zoning Board of �,,� 3. Name of Land Owner(if other than Applicant): 4. Address of Land Owner: 5. Description of Proposed Project: Accessory Apartment in Accessory Building 6. Location of Property: (Road and Tax map number)800 Depot Lane - 1000-102-2-6 .5 7. Is the parcel within 500 feet of a farm operation? "Yes No & Is this parcel actively fanned? XXYes I I 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). NAME and ADDRESS I.- 18 5 5 Me-, _ �.LChQgILP—, N&w--Yo r k 2. Grattan Family 2014 Trust, 427 Ostrander _,_Riverhead , New York 3. Polar Tree Farm L C, r W & lleyLe�o�rment .— (2 Properties) 9 West 57th Streetm Ste 4500 urk, New Tur7k--1-01-9— .............. ................................................ (Please use the back of this page if there are additional property owners) L�QAJI S / :�— 1 ——----------- SignA,Jre of Applicant —1J Date The Suffolk County Tax Map numbers may be obtained in advance when requested from the office of the Zoning Board of Appeals at 631-765-1809. 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. July 2023 617.20 Appendix B Short Environmental Assessment Form ' Instructions for Complefin �t s Part I -Project Information, The applicant or project sponsor is responsible for the completio�� esponse become part of the application for approval or funding,are subject to public review,and may be subject to eritication. Complete Part' 1 based on information currently available. If additional research or investig� Qkriwo ldd be needed to fully respond to any item,please answer as thoroughly as possible based on current information. 9 oard Of Appeals 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 James Wilsberg Name of Action or Project: 800 Depot Lane Cutcho ue, New York 11935 Project Location(describe,and attach a location map): Accessory Apartment in Accessory Building Brief Description of Proposed Action: Name of Applicant or Sponsor: Telephone: James Wilsberg E-Mail: Address: 800 Depot Lane Cutcho ue New York 11935 City/PO: State: Zip Code: Cutchogue NY 11935 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: Zoning Board of Appeals X 3.a.Total acreage of the site of the proposed action? 1 q _acres b.Total acreage to be physically disturbed? mm acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑ Rural(non-agriculture) ❑ Industrial ❑ Commercial YU Residential(suburban) ❑Forest NO Agriculture ❑Aquatic ❑Other(specify): Bed & Breakfast ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? by ZBA Approval X b. Consistent with the adopted comprehensive plan? X 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? I(Receiveri x 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical EJV�*Wftl Area? NO YES If Yes,identify: ?026 ............. 8. a. Will the proposed action result in a substantial increase in traffic above present levels.urllng Board of-MM YES !S � X b.Are public transportation service(s)available at or near the site of the proposed action? X c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: X .......... ..... 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: X 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: s e p t i c/c e s s p o o lX —----- .............. 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? X b.Is the proposed action located in an archeological sensitive area? X 13. a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? X b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? X If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: 0 Shoreline 0 Forest XXAgricultural/grasslands 0 Early mid-successional El Wetland 0 Urban Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? X 16.Is the project site located in the 100 year flood plain? NO YES X 17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, X a. Will storm water discharges flow to adjacent properties? 0 NO 0 YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: 0 NO 11 YES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: X 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? JUN 0 3 2026 X If Yes,describe: proposed 7adjoining p p rtY J NO YES 20.Has the site of the ro osed action or an roe been the subject of remediation at- completed)for hazardous waste. X If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE 22 applicant/s tsar name: WiAQLpror w_ Date: Signature: _ . Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate 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 qualityof the existing community ? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact R `' may o Lye occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage N ®3 2 126 problems? 11. Will the proposed action create a hazard to environmental resources or human health? zoning E oard of eal� 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,rmeasLires or design elements that 11ave 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 www_ww_ _ _...— 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 Town of Southold LWRP CONSISTENCY ASSESSMENT FO A. INSTRUCTIONS ARV 1. All applicants for permits* including Town of Southold ag cies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Water it @Stq@%WMqfolut "ew Law. This assessment is intended to supplement other information used by a `I`own ofold 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# 192 _ 2 _ 6 . 5 The Application has been submitted to (check appropriate response): Town Board Planning Dept. [11 Building Dept. 0 Board of Trustees 0 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction,planning activity, agency regulation,land transaction) (b) Financial assistance (e.g. grant,loan, subsidy) (c) Permit, approval, license, certification: ZBA Approval Nature and extent of action: Accessory A artment in an Accessor Buildin Location of action: 800 Depot Lane. Cutcho ue New York 11.935 � Site acreage: 1 . 87 acres Presentlanduse: Sin le Fami1v Residence H eCeIVed Present zoning classification: R-8 0 R e s i d e n t i a l ,JUN p 3 2026 0ning Board of 2. If an application for the proposed action has been filed with the Town of Southold agencTRRhfollowing information shall be provided: (a) Name of applicant: James Wilsberg (b) Mailing address: 800 Depot Lane, Cutchogue, New York 11935 (c) Telephone number: Area Code( 6 31 . 2 9 8 .4 818 (d) Application number, if any: None Will the action bbelI directly undertaken,require funding, or approval by a state or federal agency? Yes El 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. F Yes Q No X] Not Applicable 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 0 Yes 13 No X Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria 'j I" � , El Yes [ No E] Not Applicable RecLzived Zoning 'ma. ire Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria 13 Yes 13 No M Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria Yes R No E Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. R Yes [] No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. Received ❑ Yes r No[j] Not Applicable JUN 0 3 2026 'I Of Ar)oeaL Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. Yes 0 No ❑ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. 0 Yeo No 51 Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. 0 Yes ❑ No ® Not Applicable d Attach additional sheets if necessary JUN 0 3 2026 Policy 11. use of living marine resources in te Estuary and Townowaters See LWRP P Section III—Policies; Pages 57 through 6622 for luaWltriteria. Yes ❑ No © Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No© Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No © Not Applicable Created on 5125105 I1:20 AM Board of Zoning Appeals Application OWNER'S AUTHORIZATION (Where the Applicant is not the Owner) Received UN 0 3 2026 I, James Wilsber _ residing at r e (Print property owner's name) (Mailing Address) New York do hereby authorize William C. Goggins (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. Failure to comply in a timely manner may result in the denial by the Building Department of a Certificate of Occupancy, nullify the approved variance relief, and require a new variance application with public hearing before the Board of Appeals :X_ _ Q. ��s ,6 (Owner's Signature) James Wilsberg (Print Owner's Name) July 2023 APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM el The Towit of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and em pl.oyees.11 use of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. JUN 0 3, 2026 YOURNAME : James Wilsberg (Last name,first name,middle initial,unless you are applying in the name of someone else or other 6-n11qr111uWi�PeC11S company.If so,in 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) ZBA Approval 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) 13)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 of March 20 26 Signature ........................... Print NameJarnes Wilsberg July 2023 AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southolds Code of Ethics prohibits conflicts of interest on the part of town officers and&mploTees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and OWA ti)lake whatever action is necessary to avoid same, YOURNAME : William C. Go =s 111AI a 2 4 (La_;t—..-e,first name,middle initial,unless you are applying in the name of someone else orb 0 ewtm,4 s a company.If so,indicate the other person's or company's name.) Zoning Board Of Appeal 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) ZBA Approval 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 this day f March 20 26 Signature Print Name-William C. Goggins July 2023 Ie ID e TOWN OF SOUTF OLD PROPERTY RECORD CARD �h 3 OWNER STREET VILLAGE DIST. SUB. LOT 6 a ACRss REMARKS g ✓Y}r 1}�f o �i� . TYPE OF BLD. PROP. CLASS Q LAND IMP. TOTAL DATE JA 41,1 -T' c" - - 000 709 0 R 1 2 J © ! ) - `� - - _ �!F F ,117 /13 l I ,)-D 00 - 700 7 OQ 3 6 7 �o� 6� 00 � 100 3l0� I FRONTAGE ON WATER TILLABLE s FRONTAGE ON ROAD 7 �j` WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT ° TOTAL 3 3� Q4 COLOR � I Z_ E , TRIM ibl- �b i 1 r� Foundation P.c Bath Dinette M. Bldo z u = (�q�1 1��`1 — � -? c.e. f Extension Basement s A L Floors �e Kit. ,f �r a.7� _ Extension (px35 2 o 5$ ,z5- 1kc) Ext. Walls �- y,� Interior Finish S/J� L.R, Ext ns«n 13x� 6(o 5o Fire Place �} Heater �I L. D.R. � t _ 2', 5 ;2 7 z — � z C, �fS 6WA_, lLP X t? = 2-72- Woodst a BR. 8 Fin. B. Porch lou `? : I71} Dormer Deck fix(° zl h 2?4 25 5; Attic d = Rooms 1st Floor -fit (2 Garage } SOS a5 �]Kwew� '`� Rooms 2nd Floor } PoolT Lt000n a_ 7 �J6 ' _ — 1 .5700 _ r z9 -71 3 /3 .� s� -3// 7 K-0 77 :3/ N o � cnCD o Z � o � a E 0 e� CD o a � . o e. CID W ZCD Cf� ` n �..: T CD a CD ; - .. 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I u? � � li r ��° � � •. i;` �r��✓/�p��//�//✓dli rri�i'rla!���rG�%/. � ,"�,; r, � /� / +i /i��%/� �� � w� Sri rrriG,„� ✓�,/i„�,� � �,.,,✓ �, i� � /r„� r� i . �; ,� ,� J9�✓i �/I/i �//�//��r/rl/%f� .✓r�� ( r Px�j�ll�✓i'�.... ix N/xl/%%fir �">�i����, � °! ,��. i/iii. Nr�rrr: ,, k ✓ f err ,I r,err, Yy /� /f/�f/� '��'� q� III IIIIIIIIIIII IIIIIIIIIIIIIIIII IU � � ; �� / j�i !//✓�/ ll/ � I�� 1 1! III i�!�, / /r�if i�i (li' I �� ��, ;/ v�.. i a�� ✓/ � r%ri //,I��% ���i�/yid � I � f� � �j � ' r✓'/'//rb r r/ / l jG J1 q 7 Wll No', (r7r� ✓r'/i ri , �fr i; WILLIAM C. GOGGINS Attorney at Law 13235 Main Road, P.O. Box 65 Mattituck, New York 11952 " Phone: (631) 298-4818 Fax: (631) 298-4214 Received Email: gogginslawgmail.com March 5, 2026 JUN 0 3 2026 Southold Town Zoning Board of Appeals Zoning Board of Appear 54375 Main Road, P.O. Box 1179 Southold, New York 11971 Re: James Wilsberg; 800 Depot lane, Cutchogue, New York SCTM No. 1000-102-2-6.5 Dear Sir/Madam: In connection with the above referenced matter, enclosed please find the following: l. Complete Application for Special Exception Permit for an Accessory Apartment in an Accessory Building; 2. Certificates of Occupancy; 3. Property Tax Card; 4. Affidavit as to Proof of intended Occupancy; 5. Survey; 6. Floor Plan of Accessory Structure; 7. Recent Photos inside and outside of Accessory Structure; 8. ZBA Questionaire, Agricultural Form, Short EAF Form; 9. Authorization/Transactional Disclosure Forms; and 1 O.Filing Fee in the amount of$1,000.00. Thank you. Very truly yours, 1 illiam /. G 4' rgi ns WCG\ enclosures