Loading...
HomeMy WebLinkAbout8123 0 'cl-If�9 315 Old Sit 4 ()bUfih4d<,— ac) c,; hu-tt Nat 7 Sip bj)otb)� Pit I I I �0 � Apr �1�� . �I� 1 - Owner: Nicole O'Grady File#: 8123 Address: 315 Old Salt Rd Code: 17NP Agent Info North Fork Permit Expediting 36570 Main Road Cutchogue, NY 11935 Phone: 631-599-3132 Fax: Email: northforkexpedite@gmail.com zp j1� 64 i'V BOARD MEMBERS ��OF SOUj Southold Town Hall Leslie Kanes Weisman, Chairperson ,`O l0 53095 Main Road•P.O. Box 1179 Patricia Acampora Southold,NY 11971-0959 Robert Lehnert,Jr. G Office Location: Nicholas Planamento ,�`c► • �O Town Annex/First Floor Margaret Steinbugler OIiYC�UN� 54375 Main Road(at Youngs Avenue) + Southold,NY 11971 http://southoldtownny.gov RECEIVED ZONING BOARD OF APPEALS fihct 31 FM TOWN OF SOUTHOLD J U N 2 6 2026 Tel. (631) 765-1809 �L_ �ZA� S011thdd Town Clerk FINDINGS,DELIBERATIONS AND DETERMINATION MEETING OF JUNE 18,2026 ZBA FILE: #8123 NAME OF APPLICANT: Nicole and Stephen O'Grady PROPERTY LOCATION: 315 Old Salt Road, Mattituck NY 11952 SCTM: 1000-144-5-20 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type 11 category of the State's List of Actions, without further steps under SEQRA. SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was referred as required under the Suffolk County Administrative Code Sections A 14-14 to 23,and the Suffolk County Department of Planning issued its reply dated May 4, 2026 stating that this application is considered a matter for local determination as there appears to be no significant county-wide or inter-community impact. LWRP DETERMINATION: This application was referred for review under Chapter 268, Waterfront Consistency review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. The LWRP Coordinator issued a recommendation dated May 18, 2026. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department,as well as the records available, it is recommended that the proposed action is EXEMPT from Coastal Consistency Review. PROPERTY FACTSMESCRIPTION: The subject, non-conforming, 19,191 square feet, 0.44 acre, irregularly- shaped parcel located in the R-40 Zoning District measures 84.50 feet along Sailor's Needle Road, then runs south along a radius at the intersection with Old Salt Road,L=62.83 feet and R=40.00 feet and continues along the roadway, 109.00 feet,then runs along a radius L=25.26 feet and R=38.00 feet along lands belonging to the Salt Lake Village Owners' Association and continues east 84.73 feet along those lands to another radius,L=54.86 and R=140.00 then continues north 112.00 feet along a residentially developed lot to the east.The property is improved with a one-story wood frame dwelling with a covered concrete entry porch along with decking, an outdoor shower, and an asphalt driveway, a concrete walkway to the association's dock area, limited fencing, and two sheds (subject of this application),as shown on the survey prepared by Kenneth M.Woychuk,Licensed Land Surveyor last dated April 6, 2026. BASIS OF APPLICATION: Request for a Variance from Article III, Section 280-15 and the Building Inspector's April 13, 2026 Notice of Disapproval based on an application for a permit to legalize an as built shed accessory to an existing single family dwelling; at: 1) located in an area other than the code required rear yard, and in the case of a waterfront parcel, accessory building and structures may be located in the front yard provided principal front yard setbacks are met; located at 315 Old Salt Road,Mattituck,NY. SCTM No. 1000-144-5-20. ✓ Page 2,June 18,2026 #8123 O'Grady SCTM No. 1000-144-5-20 RELIEF REQUESTED: The applicant requests a variance to maintain an`as built' wood shed located in a front yard with a setback of 16.9 feet from a lot line adjacent to a roadway where such improvements are limited to rear yard locations, or in the case of a waterfront parcel, located in a front yard provided the minimum front yard setback for the primary residence is achieved. ADDITIONAL INFORMATION: The subject parcel is located in Salt Lake Village, which was created in 1940 and among other amenities offers a community dock for homeowners to share. The subject parcel is located adjacent to the waterfront parcel, owned by the association, and for purposes of this application, the subject parcel, as indicated on the Notice of Disapproval, is considered a waterfront lot. Town code permits waterfront lots to locate accessory structures in the front yard provided that the minimum front yard setback of the residential structure is met; in this case a minimum front yard setback of 35' is required. Improvements on the subject parcel are covered by the following Town of Southold Certificates of Occupancy: #Z-73 dated March 14, 1958 covering the construction of a single-family dwelling. #Z-7878 dated September 9, 1977 covering a private one family dwelling. #Z-10491 dated May 13, 1981 covering alterations to a private one family dwelling. A rental permit,#1406, expiring December 19, 2027,was granted on this property permitting a maximum of six(6) guests. The shed proposed to be maintained in its present location measures 10.1 feet by 12.2 feet and is sited 16.9 feet from the lot line at Sailor's Needle Road. A second, much smaller `Rubbermaid' shed(lean-to design) is placed adjacent to and closer to the roadway. The applicant has stated that they will remove the vinyl shed and dispose of it. The subject parcel is burdened with two front yards(Sailor's Needle Road and Old Salt Road)along with association lands used by Salt Lake Village property owners to access a shared boat basin marina. The house as sited has no true rear yard and the logical location to place a shed is where it currently stands. No member of the public or an immediate neighbor or resident of Salt Lake Village spoke in favor of or against the application. FINDINGS OF FACT/REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on June 4,2026 at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property and surrounding neighborhood, and other evidence,the Zoning Board finds the following facts to be true and relevant and makes the following findings: 1. Town Law U67-W)(b)(I). Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. Salt Lake Village is a private bayfront beach community of homes of varying size and scale developed on individual parcels that hug the landscape and take advantage of the coastline and were developed in the early- to mid-201h Century. The roadways meander and home designs follow strict association by-laws relative to color choice, etc. to maintain a community standard and harmony with other area homes. Many properties have accessory structures visible from adjoining lots including pools,accessory garages or sheds. The `as built' location of this shed is screened by mature landscaping will not impede the harmony of the community or be noticed by those using the roadway. Members of the public do not have access to the network of roads within the private community, unless invited by owners, per the Association By-Laws and as such,the shed's location will remain unknown to most of the residents of Southold Town. 2. Town Law U67-W)(b)(2). The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. The subject parcel is burdened with two front yards and a limited rear yard allowing access to the association boat basin. The placement of a shed anywhere else on the property Page 3,June 18,2026 #8123 O'Grady SCTM No. 1000-144-5-20 would be cumbersome and difficult to achieve. While not technically a waterfront parcel,the Notice of Disapproval offers the applicant the benefit to locate the shed in a front yard position, provided it meets the minimum primary structure setback of 35 feet. However, the `as built' structure is located at 16.9 feet from the lot line at Sailor's Needle Road and is well screened by a mature evergreen hedge. Relocating the shed to a compliant location would further restrict the useable yard area at the property and would create a further hardship for the property owner and applicant and possibly members of the association as the shed would be visible from the common boat basin. 3. Town Law§267-b(3)(b)(3). The variance granted herein is mathematically substantial,representing 51.7%relief from the code. However,the additional shed that is closer to the roadway(and also screened by the evergreen hedge) is proposed by the applicant to be removed from the parcel and discarded. Furthermore, as the result of a mature hedge, those on the roadway are unaware of the very existence of the wooden shed seeking relief in this application. 4. Town Law 4267-b(3)(b)(4). No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The applicant must comply with Chapter 236 of the Town's Storm Water Management Code. 5. Town Law §267-b(3)(b)(5). The difficulty has been self-created. The applicant purchased the parcel after the Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase. 6. Town Law U67-b. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of a shed with a footprint of approximately 120 square feet and measuring 10.1 feet by 12.2 feet located in a front yard with a lot line setback of 16.9 feet where 35 feet are required while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Chairperson Weisman, seconded by Member Steinbugler, and duly carried,to GRANT the variance as applied for,and shown on the prepared by Kenneth M. Woychuk, Licensed Land Surveyor last dated April 6, 2026. SUBJECT TO THE FOLLOWING CONDITIONS: I. The applicant must apply to the Building Department for a building permit for the "as built" improvement(s)within 90 days of the date of this decision and submit same to the Office of the Zoning Board of Appeals, or submit a written request for an extension to the Board of Appeals setting forth the reason(s)why the applicant was unable to obtain a building permit in the time allotted. 2. The applicant must obtain a Certificate of Occupancy from the Building Department for the "as built" improvement(s)and submit same to the Office of the Zoning Board of Appeals within 12 months of this decision or submit a written request for an extension to the Board of Appeals setting forth the reason(s) why the applicant was unable to obtain a Certificate of occupancy in the time allotted. 3. The `Rubbermaid' vinyl shed, measuring approximately 3.8 feet by 7.00 feet and located between the wooden shed granted relief in this application and the roadway is to be removed from the site prior to the issuance of a Certificate of Occupancy on the wooden shed. This approval shall not be deemed effective until the required conditions have been met.At the discretion of the Board of Appealsfailure to comply with the above conditions may render this decision null and void. That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued. Page 4,June 18,2026 #8123 O'Grady SCTM No. 1000-144-5-20 The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity, provided de minimis relief is requested within one year of the date of this decision. Any time after one year, the Board may require a new application. IMPORTANT LIMITS ON THE APPROVALS) GRANTED HEREIN Please Read Carefully Any deviation from the survey,site plan and/or architectural drawings cited in this decision, or work exceeding the scope of the relief granted herein, will result in delays and/or a possible denial by the Building Department of a building permit and/or the issuance of a Stop Work Order, and may require a new application and public hearing before the Zoning Board of Appeals. Any deviation from the variance(s)granted herein as shown on the architectural drawings,siteplan and/or survey cited above,such as alterations, extensions, demolitions, or demolitions exceeding the scope of the relief granted herein, are not authorized under this application when involving nonconformities under the zoning code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses,setbacks and other features as are expressly addressed in this action. TIME LIMITS ON THIS APPROVAL: 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. Vote of the Board: Ayes: Members Weisman (Chairperson), Acampora, Lehnert and Steinbugler. (Absent was: Plana This Resolution was duly adopted(4-0). 1 A' &J?U-4� Les ie Kaneg Weisman, Cliairperson Approved for filing " /2026 S.C.T.M. NO. DISTRICT: 1000 SECTION: 144 BLOCK: 5 LOT(S):20 (deceived MO � APR 2,0 2026 �• Zoning Board of Appe �QG�OFQP U.P. 00 S YY�I lA 0()[`7,oo N�OGrc M. 19 LOT 9 W.V.0 Q� W.V. LOT 8 eF�Qsz qsp k��Re U.P. yq`roR/�F�'qY coNc. SHOWER .... o LIGHT POLE w.. .N' n •... yF�G'�. O, MON. CONC. ..: o z D o.. .......:::'S.0' o c� 2n ......-:.:::: ... . 16.2 �2 O� .:._ ::....:.::•I STY FRM.:::::::.:..:.:.;::. MON. lT .........DWELLING......::::::�. . ............... 00 ¢ V� O a� II It LU t-� N rd 09 U.P. 0�, LAND NIF OF 0 0 SALT LATE PROPERTY owNERS aSSOCIATION R - n6� FINAL MAP W.0 REVIEWED BY ZBA DECISION# DATED: � o�C7 FEMA MAP#36103C0482H eFFECTIVE 0912512009 THE WA7ER SUPPLY, WELLS, DRYWELLS AND CESSPOOL LOCATIONS SHOWN ARE FROM FIELD OBSERVA71ONS AND OR DATA OBTAINED FROM OTHERS. AREA: 19,191 S.F. or 0.44ACRES RELOCATE VINYL SHED 04-06 26 ELEVA71ON DATUM: UNAUTHORIZED AL7ERA710N OR ADD17ION TO THIS SURVEY IS A WOLA77ON OF SEC77ON 7209 OF THE NEW YORK STATE EDUCA71ON LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID 7RUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO 7HE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE 717LE COMPANY, GOVERNMENTAL AGENCY AND LENDING INS77TU77ON LISTED HEREON, AND TO 7HE ASSIGNEES OF THE LENDING INS717U710N, GUARAN7EES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO 7HE:STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES, ADD177ONAL STRUCTURES OR AND 07HER IMPROVEMENTS EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARAJVTEED UNLESS PHYSICALLY EV/DENT ON THE PREMISES AT THE AAAE OF SURREY SURVEY OF: LOT 8 of NE'ry CERTIFIED TO: STEPHEN O'GRADY; NICOLE O'GRADY; MAP OF: SALT LAKE VILLAGE ����\A M ¢ oy�0 FIDELITY NATIONAL TITLE INSURANCE COMPANY; �cr=� FILED: MAY 10, 1940 No. 1310 x SITUATED AT: MATTITUCK r x o TOM OF: SOUTROLD KENNETH M WoYCHUK LAND SURVEYING, PLLC SUFFOLK COUNTY, NEW YORK �20 05 sa Professional Land Surveying and Design N - 7 P.O. Box 153 Aquebogue, New York 11931 PHONE (891)298-1688 FAX (891) 296-1588 FILE #225-134 SCALE:1"=2O' DATE:JULY 20, 2025 N.Y.S LISC. NO. 050882 FORM NO. 3 TOWN OF SOUTHOLD ` BUILDING DEPARTMENT SOUTHOLD,N.Y. Roc'elved n NOTICE OF DISAPPROVAL APR 0.205 DATE: Februa �0 Appeals RENEWIA kE A0,2026 TO: McDermott T&R Irry Trt Iv PO BOX 343 315 Old Salt Rd PO BOX 343 ` Mattituck,NY, 11952 Please take notice that your application dated December 19, 2025: For permit to: legalize an as built shed accessory to an existing single-family dwelling at: Location of property: 315 Old Salt Road, Mattituck,NY County.Tax Map No. 1000— Section 144 Block 5 Lot 20 Is returned herewith and disapproved on the following grounds: The as built construction, on this non-conforming 19,191 sq.ft. parcel in the Residential R-40, is not permitted pursuant to Article III, Section 280-15, which states accessory buildings and structures shall be located in the required rear yard and in the case of a waterfront parcel, accessory building and structures may be located in the front yard provided principal front yard setbacks are met. The survey shows the front yard setback of 16.9 feet, which does not meet the required front yard principal setback of 35'. Oaf juj thorized Signat Note to Applicant: Any change or deviation to the above referenced application may require further review by the Southold Town Building Department. CC: file, ZBA ' Soo FORM NO. 3 m TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL DATE: February 10, 2026 TO: McDermott T&R Irry Trt PO BOX 343 315 Old Salt Rd PO BOX 343 Mattituck,NY, 11952 Please take notice that your application dated December 19, 2025: For permit to: legalize an as built shed accessory to an existing single-family dwelling at: Location of property: 315 Old Salt Road, Mattituck,NY County Tax Map No. 1000—Section 144 Block 5 Lot 20 Is returned herewith and disapproved on the following grounds: The as built construction, on this non-conforming 19,191 sq.ft. parcel in the Residential R-40 is not permitted pursuant to Article III, Section 280-15, which states accessory buildings and structures shall be located in the required rear yard and in the case of a waterfront parcel, accessory building and structures may be located in the front yard provided principal front yard setbacks are met. The survey shows the front yard setback of 16.9 feet, which-does not meet the_r_esluixed front yard principal setback of35'.- 4AQ1P0JA (�YIJUIPA A orized Signatur Note to Applicant: Any change or deviation to the above referenced application may require further review by the Southold Town Building Department. CC: file, ZBA 3 APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS AREA VARIANCE Received House No. 3 If Street © 4 11" Hamlet M 4 I -/ I- APR r ;2026 SCTM 1000 Section: Block: JLot(s) 0 Lot Size: / Zone '1 0 oning oE�ari�oi Appeals I(WE) APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED BASED ON SCU V Y/SITE PLAN DATED o 6-0,5)Lge Owner(s): wA? fi Y fi Mailing Address: P • iJ a �� /'l a?—fil Lf( �J ��� T 2 Telephone: )/Z^ Ll I I Fax: Email: NOTE: In addition to the above,please complete below if application is signed by applicant's attorney,agent, architect,builder,contract vendee,etc.and name of person who agent represents: Name of Representative: e/19,, a D o z '1— for Owner( ) Other: Address: ;To M a ( h �j � C ✓cr f a o � t/t /� Y �/�.�� �? r Telephone: f q — 3 Fax: Email: 4 h?ti (-"o AY e X ee,?li re— (' !KA 1 .0 oW Please check to specify who you wish correspondence to be mailed to,from the above names: ( ) Applicant/Owner(s), 00 Authorized Representative, ( ) Other Name/Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN DATED 7 J and DENIED AN APPLICATION DATED ), /I 01Z o 40OR: ( ) 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 npt quote the code.) Article: 1/f Section: R �Q u® Subsection: Type of Appeal. An Appeal is made for: t,�"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, Whas not been made at any time with respect to this property, 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 Received REASONS FOR APPEAL (Please be specific, additional sheets may be used with preparer's signature notarized): APR 2 0 2026 1. An undesirable change will not be produced in the CHARACTER of the neighborZarj�tt bggiQ)i Appeals nearby properties if granted, because: /I- I f e z h 1, Ft For A 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: rr'0 W V/C-V . 3.The amount of relief requested is not substantial because: ll /J'tlr 5tie� D F 122 S4�eIL /zc.T 4. The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: f l f -e vc r f yeOL Kf 5. Has the alleged difficulty been self created? { } Yes, or {?C} No Why: • Are there any Covenants or Restrictions concerning this land? { } No KYes (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. ignature of Applicant or Authorized Agent ( (Agent must submit written Authorization from Owner) Sworn to before me this / day ofItilD , 20� SANDRA V, SAIEQI•INOTARY PUBLIC,STATE OF NEW YORK Registration No. 02SA6407223 Notary Qualified in Suffolk County Commission Expires 05/18/20,?8 Zoning Board of Appeals APPLICANT'S PROJECT DESCRIPTION Received APPLICANT: ��9 Z0 1 a��ti SCTM_No, I®�J U ��'/�/ —'� —" .�� - APR ,2 0,2026 1.For Demolition of Existing Building Areas Please describe areas being removed: V� Zoning Board of Appe: U.New Construction Areas (New Dwelling or New Additions/Extensions): Dimensions of first floor extension: Dimensions of new second floor: Dimensions of floor above second level: Height(from existing natural grade): Is basement or lowest floor area being constructed?If yes,please provide height(above ground) measured from natural existing grade to first floor: III. Proposed Construction Description (Alterations or Structural Changes) (Attach extra sheet if necessary). Please describe building areas: Number of Floors and General Characteristics BEFORE Alterations: c Number of Floors and Changes WITH Alterations: IV.Calculations of building areas and lot coverage,sky plane(From Surveyor,Design Professional): Existing square footage of buildings on your roperty: 1,500 Proposed'increase of building coverage:_ 11 e< 0 a �- Square footage of your lot: qf Percentage of coverage of your lot by building area(lot coverage) lv 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 Sky Plane?(Please refer to Chapter 280, Section 280-208 of the Town Code): V.Purpose of New Construction: 5✓ 1 K �S 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: Please submit 8.sets of photos,labeled to show different angles of yard areas after staking corners for new construction,and photos of building area to be altered with yard view.. Revised 6/2023 QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION A. Is the subject premises currently listed on the real estate market for sa eceived Yes No B. Are there any proposals to change or alter land contours? APR 2 :2026 _�S_No. Yes, please explain on separate sheet. zoning ,-ppeals C. 1.) Are there areas that contain sand or wetland grasses? 1(/ 0 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? 4.) If your property contains wetlands or pond areas, have you contacted the Office of the BOARD OF TRUSTEES for its determination of jurisdiction? Yof Please confirm status ofyour inquiry or application with the Boar of Trustees: Ili/ IL J J6 MI -t- a Q0VIIC•, 4 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? W D E. Are there any patios, concrete barriers, bulkheads or fences that exist that are not shown on the survey that you are submitting? &r 0 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? kf O If yes, please submit a copy of your building permit and survey as approved by the Building Department and please describe scope of work: 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? Al 0 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 ftn4 /e F4 - I1y 1/Jc (examples:existing single family,proposed:same with garage,pool or other) AuAu h roro izeds gnature Date (2015) The Code of Salt Lake Village Preamble Received In Order To: Perpetuate the delightful environment of the Community APR 2 U 2026 Enhance its beauty Protect its values Zoning Boardofi Appeals The members of Salt Lake Association,Inc.,jointly and severally agree,to this Preamble and the following Principles: 1. General a.Protection of the Rights of each property owner is a responsibility of all members of the Village.By contributing respect and consideration, each one is assured the privacy he or she chooses, and the friendliness from all members of the Community. b.A property owner,when planning to sell or rent has the responsibility to respect the meaning of the above Preamble and the Principles listed herein.He or she is obligated to advise brokers and interested Buyers and Tenants of,"The Code of Salt Lake Village". c.Property owners are responsible for the conduct of their dependents, guests,tenants and employees and to inform them of our Code. 2.Architectural Design—New Homes and Additions to Existing Homes a. The exterior appearance of such construction is to conform to the general architectural design of the existing homes and out structures. b.Dwellings are restricted to one-family c.Buildings shall conform to the current code of the Town of Southold for single family residential homes. First floor living area to have not less than 1,000 square feet. d.Exterior walls and trim to be white in color e.Roofs to be either green or black f. Window shutters to be either dark green or black. g.All out buildings shall conform to the above colors for the home h.All fences shall conform to the Town of Southold rules and regulations and be white in color. 3.Landscaping,Lawns and Hedges a.All planting, including hedges,to exhibit a sense of beauty. b.All open ground,except service and planting areas,to be in grass lawn. c.All vegetation to be properly maintained.Lawns and hedges to be kept neatly trimmed. 4. Cesspools and Fresh Water Wells. a.Locations and construction specifications of all cesspools and fresh water wells to conform to the Health Codes of Suffolk County, Town of Southold and Salt Lake Village Association,Inc. 5.Village Roads a. Speed limit for vehicles is to 15 miles per hour or less. b.Road repair and maintenance expense is to be assessed to all property owners on a pro-rata basis, except as covered in C. c.Damage to roads caused ehicles performing a service for a property owner shall be repaired and paid for by the owner. d. Snow removal costs are to be shared on a pro-rata basis by all (2� members from the Association's treasury. e.End of roads are private property and not to be used as "turnarounds". �Peived 6.Boat Basin APR .2 0.-2026 a.Facilities are restricted to use by members and their invited guests. . b. The use of the facilities obligates such persons to respect the rights Zoning Board of Appeals of property owners whose land adjoins the Village owned bulkheads, docks, common areas and walkways. c. Swimming is not allowed in the boat basin.Persons disregarding this assume all risks. d.All children 12 and under be they children of owner's or guest's must wear a Coast Guard approved floatation device(life preserver)when on the boat basin dockage. e.Dumping of refuse anywhere in the Village, discharging boat heads in the boat basin or near any waterfront property is prohibited. f.Late night partying, swimming, disorderly conduct,boisterous language and obnoxious conduct is prohibited. g.There are currently 7 boat slips in the boat basin"marina".All slips are to be assigned on an annual lottery style process (Drawing names from a hat) . The current cost of a slip is$1,000.00 per boat per season. Only property owners may enter the lottery initially. Should slip be available after owners needs have been satisfied then boats of children of property owners and second boats of owners may lease a slip on a lottery style process among this class. h. In the event that there are more private property owners desiring a boat slip,the HOMEOWNER(S) losing out in the lottery shall be reimbursed by the winners of the lottery on a pro rata basis for the difference of off sight dockage and$1,000.00 or the then cost of occupying one of the Village's slips. Only one boat slip is to be available to any property owner. The losers of the annual lottery are guaranteed a slip the following year. i.No tenants, guests or third parties of property owners are to rent boat slips in the marina unless approved by a majority of homeowner. 7.Village Common Areas,Roads and Beach a.Every effort is made to keep the area neat and tidy. 8. Beach and Right of Way a. The rights of property owners whose land adjoins the Beach Right of Way and Village roads are to be respected at all times. Guest and family members are to be told of the size and extent of the beach. The village beach is 100 feet wide as measured fifty feet on either side(east and west of)of the midpoint of the steps leading down to the beach. Beyond that is private property to the mean high tide line. b.Any person consuming beverages or food on the Beach are to be responsible for any refuse left on the beach and remove the refuse to their private property. c.Fires are not allowed on the common property or Beach. d.No Life Guard is on duty.Bathers assume all personal risks. 9. Other Restrictions a. Owners are prohibited to burn rubbish or refuse. b.All pets that are taken off owner's private property are to be held on a leash in accordance with the rules and regulations of the Town of Southold. C.No pets on Village Beach d.Performance of repairs, others than minimal,to mobile equipment, boats, and vehicles, shall not be performed in public view. e. Owners or their guests shall not park or store campers,trailers, VItrucks and unsightly vehicles and objects on their private property or common area or roads of the village.f.All boats stored on private property must be out of public view. Received g.It is each property owners responsibility to politely request outsiders they observe to leave the private property of the Salt APR 2 .0 2026 Lake Village,Inc.,if not an invited guest or service employee. Zoning Board of Appeals FORM NO. 4 TOWN OF SOUTHOLD v BUILDING DEPARTMENT Received TOWN CLERK'S OFFICE SOUTHOLD, N. Y. APR 2 0 2026 Zoning Board of Appeals CERTIFICATE OF OCCUPANCY No Z. 73. ........ Date .... March. V.... ............... .....19..5$. THIS CERTIFIES that the building located at ...,prJ;pgte, Road............ . ........ ........ Street Map No Salt. Lake •'i illa&ock No .... ... .. ...... . ......, Lot No 11_1......iattltUokj•• N.Y. conforms substantially to the Application for Building Permit heretofore filed in this office dated .................... ........19.58..., pursuant to which Building Permit No .........:.Z...206...... dated .. . . ........,Tarit�atg.•3.fJ 19...5&, was issued,and conforms to ail of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ............ . .......... . . ............ . ....... . ...PRIVATE..DUIX ING....................... . .................. ......................... This certificate is issued to ..... ..Henry.....Koch .........(.--evae . ............ ..................... ............... (owner, lessee or tenant) of the aforesaid budding Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT Received Town Clerk's Office Southold, N. Y. APR ;2 0 2026 Zoning Board of Appeals Certificate Of Occupancy No. Z787E . . . . . . Date . . . . . . . . . . . . . .Sept . . . 9. . . . ., 19.77. THIS CERTIFIES that the building located at . .c►l c,. j t. ha&d • • • • • • • . • • Street Mallo V: USN No. . . . . . . . . . .Lot No. . . . . .p i y y s �r tr . . . . . . . P �Alli La � t• t-ituck. . .LV v, ' . conforms substantially to then code buiAedbef'ore r;rpr �3. . . . . . . .. 1977. . pursuant to whicft� ccupanc�* z7878 " dated . . . . . . . . . . .;;e p t. . 9. . . ., 19 77 ., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is pi-iva.te -one. •family-dwelling. • • • • • • • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to -Ar.t.1ur. -H l •1•1-rich . . . owner • • • • • • • • • • • • • • • • • • • • • (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval pre— •eai:sting • • • . • • • . • • • • • . • • • . UNDERWRITERS CERTIFICATE Noire-erxist•ing• • • • • • . • • . • • • • • • • • • • • • • • • . HOUSE NUMBER . . . . 3.1.�r. . . . . . Street • •Old• B•a1 t• Road• • • • • •fd-at t i tuck• • • • • • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspec r FORM NO.4 TOWN OF SOUTHOLD Receive BUILDING DEPARTMENT Office of the Building Inspector Town Hall -N/PAPR 2 0 2026 Southold, N.Y. Zoning Board of Appeals Certificate Of Occupancy No. . . .11.0491. . . . . . . Date . . . . . . 24.$y. .13. . . . . . . . . . . . . . . . . .. 1981. THIS CERTIFIES that the building . . . . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property 315• .Old. S•a1t. Road,. . . . Street eMat.t.ituck, .No .York . . House No. Hamlet County Tax Map No. 1000 Section . . 1.4.4 . . . . . .Block . . . P.5 . . . . . . . . .Lot . . . 02 Q . . . . . . . . . . Subdivision . .Sa1.t :Laka .Vi1.lage. . . . . . . . .Filed Map No. . . 13.10.Lot No. R . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated October. .23• • • • • • . • • • • • • • • , 19 .80pursuant to which Building Permit No. . . . .1091+.5 .Z. . . . . . . . . dated . . . . .October• 2.7 . • • • • • • • • • . 19". .80was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this Certificate is issued is . . . . . . . . . . . . . . . . . . .Add:Ltl.Ono. .and. .41te.r4t IPA ,tp, .Pr ly.Mq. Pn.- .F1r+.Ri3.Y. t?r Xing. . . . The certificate is issued to . . . . . .Rdwar.d . an•d .Cath er, ne.Buckl y. . . . . . . . . . . . . . . . . . . . (bwwlrrrwwwrr wwrw of the aforesaid building. Suffolk County Department of Health Approval . . . . . .X/.�„ UNDERWRITERS CERTIFICATE NO. . . . . N./.R . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . Building Inspector Rev.1/81 /� � a lip •lY % _. a AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS TOWN OF SOUTHOLD 00 WHEN TO USE THIS FORM: This form must be completed by the applicar any special use permit,site plan approval, use variance, area variance or subdivision approval on �pin an agricultural district OR within 500 feet of a farm operation located in an agri tural district. All applications requiring an agricultural data statement must be referred to the Sufj 01k, C'gfe Department of Planning in accordance with Section 239m and 239n of the�i unicipal Law. l. Name of Applicant: 2. Address of Applicant: 3. Name of Land Owner(if other An Applicant): 4. Address of Land Owner: 5. Description of Proposed Project: 6. Location of Property: (Road and Tax map Number) 7. Is the parcel within 500 feet of a farm operation? { } Yes { } No 8. Is this parcel actively farmed? { } 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. 2. 3. 4. 5. 6. (Please use the back of this page if there are additional property owners) Signature of Applicant Date Note: 1. The local Board will solicit comments from the owners of land identified above in order to consider the effect of the proposed action on their farm operation. Solicitations will be made by supplying a copy of this statement. 2. Comments returned to the local Board will be taken into consideration as part as the overall review of this application. 3. Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above. The cost for mailing shall be paid by the Applicant at the time the application is submitted for review. lr 617.20 Appendix B Short Environmental Assessment Form aQR 2026 Instructions for Completing 0°aid °{ APpe - �p�in� Part I-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part l 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 I. 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 r Name Action or Project: / �+ c-C ked Project Location(describe,and attach a location map): /c - fi f t./ & e Brief Description of Proposed Action: Name of Applicant or Sponsor: Telephone: G 7 f„ T 9 q _ ? ,L_ ' c't.__ E-Mail:���pG� Cak�re¢ia �. co Address: W City/PO: State: Zip Code: 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinan e, 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: 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? _acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑ Urban ❑Rural(non-agriculture) ❑Industrial ❑CommercialResidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page I of 4 r� 2� 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ® �Q, X b.Consistent with the adopted comprehensive plan? AQR i� 6. Is the proposed action consistent with the predominant character of the existirtW&A r"e al NO YES landscape? 106119 FK 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: X 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? X 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: I I-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? r13.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? es,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? 16.IS the project site located in the 100 year flood NO YES plain? eV Will the proposed actio Iff Yes, n create storm water discharge,either from point or non-point sources? NO YES a.Will storm water discharges flow to adjacent properties? `(NO❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO❑YES Page 2 of 4 -6W) 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: Rec�Nlad 6 19.Has the site of the proposed action or an adjoining property been the location of an active or closed N YES solid waste management facility? Board of A If Yes,describe: ZOnin9 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: 0 1 11 Date: ® 2 C Signature: 12 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. Willrthe proposed action create a material conflict with aril 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? P-V,, proposed action cause an increase in the use of energy and it fails to incorporate ly available energy conservation or renewable energy o portunities? roposed action impact existing: lic/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, l/ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 1� Red9IV0Go,or Moderate small to large et impact APR 2_0 m may occur occur 10. Will the proposed action result in an increase in the potential for erosion,fioo3M2i9i9dAgR e 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 Page 9 Use Variance Application, Revisipn Nov. 2023 S��-b�? Board of'Zoning Appeals Application OWNER'S AC1'I'HORIZATION APR 0 Zo26 (Where the Applicant is not the Owner) Zoning Board of Appeals 1 J j�CC�(�d residing at315 D U /g/7 ✓d/ Ma bZ 7ilclf ,, (Priinnt"p`roperty owner's name) (Mailing Address) j do hereby authorize ���.10 0 j— O Z' (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 Cleric,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 COIYIPLIANCE WITH THE CODE REQUIRED TIME FRAME DESCRIBED HEREIN. ��er's Signa re) (Dated) (Print Owner's blame) Rovis.ed 12/30/2025 j APPLICt1NVOWNER TRANSACTIONALDISCLOSIICZE [+'OI�f1I 1"hc To n of`;outholcl's Code of I thics nrahibits conflicts of interest on the part of town officer. end employees "I"he purpose of (his form is to wo•ide information nmch call alert the town of ovsible conflicts of interest.tnd atloss it to take svhatcver ion is necessary to avoid same. YOUR NAME : l202 (Last no--mc,fiat name,middic initia.unless you are apply int;in the name of someone else or other entitn}�Sstct , b company,il'so,indicate the other person's or company's name.) H tC TYPE OF APPLICATION: (Check all that apply) 0609 Board of Pppeav-- Tax grievance Building Permit Variance Trustee Permit Chri 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?"12clationship"includes by blood,marriage,or business interest. `Business interest" nica ns 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 otivns more than 5% of the shares. YES NO ifyou answered"YES",complete the balance of this form and date and sign where indicate(]. tiame 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 chilli 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 57' � day f Signature �![�. _ T /_(/✓l�y'�e _�, tlC- IPrint itiameS` � 1� L?�7Nkt— AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Cam ' v The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose 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. YOUR NAME : F 10 L t-L_ (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,cu company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) PR p 2020 Tax grievance Building Permit Q Variance Trustee Permit � atd of Pppea Change of Zone Coastal Erosion �p�in9 50 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 day of ,20 22 L Signature tz: Print Name �t 9 / 0 19 e- "� 1s s, I2� Town of Southold LWRP CONSISTENCY ASSESSMENT FORM ApR ® 20�6 A. INSTRUCTIONS aoard 0', P•Ppe2J� �or�n9 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes",then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if rieecessary; 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 (southoldtowh.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# D b - 11 _- The Application has been submitted to(check appropriate response): Town Board Planning Dept. [�( Building Dept. E 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: S � � kc- 0 �- Location of action: Site acreage: J o Present land use:0 F Present zoning classification: t7 7-onin9 B°ard of APPeals 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: /'9/ v 0 o j✓ '1— (b) Mailing address: 3 /�'1 h (� �✓ 3 .s (c) Telephone number: Area Code( ) G / — s — '30 (d) Application number, if any: Will.the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ❑ No If yes, which state or federal agency? DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space,makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—.Policies; Page 2 for evaluation criteria. ❑Yes K No ❑ (Not Applicable- please explain) 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 Z No ❑ (Not Applicable—please explain) Attach additional sheets if necessary �,�� Policy 3. Enhance visual quality and protect scenic resources throughout/ gown of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria d T Yes rsz No 0 (Not Applicable—please explain) Board oA Pppea`c �.,n1n9 Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria Yes �No (Not Applicable—please explain) Attach.additional.Amm if nece-ssary.._.._ 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 Ed Yes LN No 0 (Not Applicable—please explain) Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. Yes �NoD (Not Applicable—.please explain) WAri Attach additional sheets if necessary ® 2026 APR . Policy 7. Protect and improve air quality in the Town of Southold. See LWRfPA � � III — Policies Pages 32 through 34 for evaluation criteria. See Section III—Policiy§ ep t�irough 38 for evaluation criteria. Yes LIS No (Not Applicable—please explain) 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 Ld No 0 (Not Applicable please explain) 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 Yel�A No 0 (Not Applicable—please explain). Attach additional sheets if necessary WORKING COAST POLICIES 1 � 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 41 through 56 for evaluation criteria. Yes N No 0 (Not Applicable—please explain) - �QR psa BOOS Attach additional sheets if necessary ZO�� Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. Yes No Not Applicable—please explain 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. E Yes IV No 0 Not Applicable—please explain 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. 0 Yes No 0 Not Applicable—please explain w 4-4- r'. Nil ► I. +,► L • � � 1 ��'• '" �rS_r� • • ►fir �� I IV: � CC : a• Ar Ll 1�1 " '- -� •f . Received ' s ' •~ i- ; Zoning Board of Appeals s' Ir 1 3 'e. IrO, t 0 2a2� kk o � AP lib guard : y .i /10 Its i eve_ ? Zoning Boar NAPA -- �yo• .. ....wwsw.+. - n � _ N ✓ice •, �i y 6 t�• :�i .mil .Ar '�f •. ��� ,-l�` trot i Q � •y .1 � 1 r T I rl�� �11�Li x• • APR 2 0 2026 • 1 r- 4 ail( 1 •r l' 1 A r hI , a 1 1 ♦ � r � �9 C • ...- ram r.--T i w V7'..r - y/ 0 TOWN OF SOUTHOLD PROPERTY RECORD C RD r` STREET VILLAGE DIST. SUB. LOT T FORMER C WNER , iv� - i S V4` TYPE OF BUILDING RES, SEAS. VL rARM 'Comm. cE. Value LAND IIMP, �y TC '._ DATE RE;Y.ARKS € k a w f '♦r _ r rit#ore t�✓ �' ..#� 1 I/ � 7 AGE -- BUILDING CONDITION # — '(m b A11C, NEW NORMAL BELOW � ABOVE �-� -� . F, ��� �`:� vv FAPit Acre Value Per A Value �7 r Acre N _ 1L�'- -=�5 , t7C �rr� �fii �" tJf/rs ..' , ► Tillable I (� N O t ✓, �t { v Tillable 2 _ .. 1 d Tillable 3 Woodland Swampland �--� FRONTAGE ON WATER ! Crushlond !FRONTAGE ON ROAD House Plot DEPTH iBULKHEAD I Total DOCK _ )LCR 6 x r S t TRIM. t } bo to Y i t r n^ ' s E I i i / 64 .#5 Foundation j Both ;Dinette Floors Extension Basement jj) ry Ext. Wolls S ;Interior Finish #, LR. Extension f i w } Extcn , Fire place Heat k DR. S ' ;Type Roof Rooms 1st Floor B R. _7 - ---k---- Porch Reereotion Rootnj Roams 2nd Floor iC3. B: F Porch Dormer m r .. Breezeway'p r, y Driveway r Y Patio Total s ww f CD -v o Cp o N } Y 3" I' Y A r DIMENSIONS HIDDEN FOR PREVIEWS swoop, cQ n CD W 0 o � .... CD C- o c CD ; D � r •ems DOOR AND -----._.__ WIODOW .Y PLANS /NC'L t1DED �_ � �r sr r•zeti e3 E;-�I�i WiWr�ala•akdr jywy ti d.z RItrGe j'i4Ri1� E 3Y •s�. . [Y 4IM� r• a. Q41F a/a3ve yi' plt ; Jr .� .... . , .. t► Jr M'1yr.grow t s.+�kn+y1MR ,�.>r air fw.yr sR�e ".� Ya �. ok (D—_.,,.._.. r. 7.7 � +Jwsmle tail a�- CD I � { 2 el • Lw-bw IhrOn*00.JMAnt t ��...' •4 C • f -- -- J r UpGaA •ai.Rr.�ya a.a a•:. h11R "� i'.r*VWA'o61 S.:ery RYMfW ty t! aR +.s- r�0or P iAk1% a, rim l s adraw SYt/a,.i Y+'S�aas.l irrli arH.'..•eariYii•1uap+ni'•�1 Y Yssa i�lL-'1•a.na..••%may lr. ! COMPLETE MATERIALS AND CUT LIST a m F F IIIi � MAW k h ) i I 7 }} s - - xx., 1/2" PLYWOOD (XXXSF) - (a (D O � y � _ O o D CD oa m it 1 a <r ,� ZBA CHECK FEES - 2026 Funding Account-B2110.10 DATE NAME ZBA FILE# FEE CHECK# DATE SENT TO TCO 4/20/2026 O'Grady 8123 $1,500.00 225 4/30/2026 AMP Architecture for:CLOUS, 4/23/2026 JAM ES 8124 $1,250.00 3528 4/30/2026 4/24/2026 Dobert 8125 $1,500.00 102634 4/30/2026 $4,250.00 n of Southold P.0 Box1179 Southold, NY 11971 * * * RECEIPT * * * Date: 05/01/26 Receipt#: 355062 Quantity Transactions Reference Subtotal 1 ZBA Application Fees 8123 $1,500.00 Total Paid: $1,500.00 Notes: Payment Type Amount Paid By CK#225 $1,500.00 Lopez, Eligio Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Lopez, Eligio 36570 Main Rd Cutchogue, NY 11935 Clerk ID: SABRINA Internal ID:8123 TOWN OF SOUTHOLD l� ZONING BOARD OF APPEALS Appeal No. V SOUTHOLD, NEW YORK B' AFFIDAVIT ' OF �r In the Matter of the Application of: MAILINGS G DerV►0. -- I( I & V �'' (Name of Applicant/Owner) Sq 117 ", SCTM No. 1000- (Address of Property) (Section,-Block & Lot) COUNTY OF SUFFOLK STATE OF NEW YORK I, ( ) Owner, Agent 1�2 residing at 1 h /i' tG c1 c h ,a V� New York, being duly sworn, deposes and says that: On the l.S day of M aY , 20'1 I personally mailed at the United States Post Office in-�S v vt k i I el ,New York, by CERTIFIED MAIL, RETURN RECEIPT REQUESTED, a true copy of the attached Legal Notice in Prepaid envelopes addressed to current property owners shown on the current assessment roll Verified from the official records on file with the ( ) Assessors, or ( ) County Real Property Office, for every property which abuts and is across a public or private street, or vehicular right-of-way of record, surrounding the applicant's property. (Signature) CONNIE D.BUNCH Sworn to before me this Notary Public,State of New York a� day of, > , 20 No.01BU6185050 Qualified in Suffolk County L Commission Expires April 14,2 � r�P (Notary Public) PLEASE list on the back of this Affidavit or on a sheet of paper, the lot numbers next to the owner names and addresses for which notices were mailed. All original USPS receipts and mailing confirmations to be submitted to the ZBA Office along with this form completed, signed and notarized. P FPO- TM PostalPostal CERTIFIED MAILO ■ ■ ■ O ■ ■ Ln Domestic Mail Only Domestic Mait Only m m CO ° M Certified Mail Fee _r, ,i fag{1 M Certified Mail Fee ° 1 11 Erf 95� 9-�� i m $ i t 19 m $ , ;t`� Extra Services&Fees(check box,add fee aslfy7f ete) ',d�� Extra SeN(ces&FeeS(checkb edd lse p te) a�•,r� Jr i�•J a LnJ �g Ro B ❑Return Receipt(hardcopy) $— 11f_ �Cj „�>�.,,;;/,)�ti I Rf ❑Return Receipt(hardcopy) $ rJ_°�ii_� v rry PP' py e• t p ❑Return Receipt(electronic) $ 1° 1 Q Postmark ? I O ❑Return Receipt(electronic) $ s 1 1!19Z®l pest f O ❑Certified Mail Restricted Delivery $ 111 i 'y� Here .�e,!'tt C3 []Certified Mall Restricted Del, ry $ °��( ,.,, 3.drm� C3 []Adult Signature Required $ $iI 1!1t I—j rt; []Adult Signature Required $ r�-, , � ��� Fi ✓llfVl� []Adult Signature Restricted Delivery$ -- ' ;a. - e,� q []Adult Signature Restricted Delivery$ `'y i r� Postage r tJ° �'6, Q���av' rQ� r�� Postage $0°7v � � III T I s/he and Fees �ac� 1/�I_I Er�C>> T I pos a and Fees 0�/15 �026 _. SS fv ru S�f t To ru Sent Taj t � h�! p c �_ J c^ U �---a S v__S a�I u1 Q - rt Y ? __... - � - S r t and Apt.No r PO Box IVo: M1 Str et and Apt.No.,or I'D fox No: 0 - ci L --- -------- - ----- r -- �---�----- ----------------- �Sta Z�+�`I ?' Cl Y . 2. C�ty,PpYr l :.• . .. ....,, :.. r .. ..- ■ / Postal i I CERTIFIED ' O ■ ■ i ■ , ■ ■ Irk nJ Domestic 'DomesticOnly im m ICO u 1 u 1 a P I � 'i�() m Certified Mail Fee d t._t. tl_I m Certified Mall Fee I �I• v e Er - m $ �` t Extra Services&Fees(check box,add fee Extra Services&Fees(check box,add fee as$jff J�e)/h '9� ��i`-;(t ❑Return Receipt(hardcopy)rU $ p ❑Return Receipt (hardcopy) $ v r••r- ;6 '� �� .F_ 0 ❑Return Receipt(electronic) $ $ 1.. J(�Q:er a ❑Return Receipt(electronic) $ °l(1_) -�� �,� ❑Certified Mall Restricted Delivery $ c G' -ere i�'- O p P�pstmark v 0 +DO i O ❑Certified Mall Restricted Delivery $- $Il_1-III t( H r6 ,�� [] ❑Adult Signature Required $ $r'�T ,.0 ❑Adult Signature Required $ rk I i i u`r i'��, `, ,�+r []Adult Signature Restricted Delivery$ ❑Adult Signature Restricted Delivery$ ED Postage �1 :• Postage $1�1°7u �/ r( 7a , $ °73 f t�� 4� iy r $ _ r $0 eostpae and Fees ' { fU To$V FPs"e and Fees b j 1 i°44t�rt !�/ L $ - -— v $t and pf.No.oiT'l3 x No. :l ru rU Sent Tru o p C C I C 0 -- / ------------- O Street and A t.No.,or Pd Box No. 1 .r� 1 t7 - 2 .. - ....................---------------------- ---------- D �fl 0/�V. ,� n stets, /P �. - ,State,ZIP+4rD-- � r -- oar / �w �he. I1V I1 Sao w ., Postal -0 CERTIFIED o RECEIPT ! CERTIFIED ° ■ i m /. / /. • CD m co Gr m Certified Mail Fee Qd -ice frl. Certified Mail Fee c 7jr Er - Oal m Extra Services&Fees(check box,add fee es Jbp -a) '?, ?i m Extra Services&.Fees(check box,add iee ro ) �� A���"" '^ ru ❑Return Receipt(hardcopy) $ _„1_II �./° ❑Return Receipt(hardcopy) $ ° � r ❑Return Recelpt(electronic) $ .. n{:/ t tm rk tP _^w Return Recel t electronic) $ 1�.1 Postmark 1-3 ❑Certified Mall Restricted Delivery $_ rt'�*.T�J rn l At,7U Hergv ? 4 a ❑ p( r� 4�_•' ❑Adult Signature Required $�-,__�-,�� \\ []Certified Mail Restricted Delivery $�,i,--�ifl /3, r►{' re ry,, f] []Adult Signature Required $ c�.�T ��"�" t~ sec []Adult Signature Restricted Delivery$ ❑Adult Signature Restricted Delivery$ - rn\� Postage �'••,. _. ..._....... ' �rq $ $0.78 o �(A ��7r�� � Postage r�l�°�� ��`�f�— "�� rUTotal Postage and Fees f�5/15/ry ?h $ru �s and Fees tic,�r�r ry �" $$10.48 I rru Se o p I T� ru Sent To !M or► Gt ht nh TJ vv -- ---------- --- ---- ---------------------------------- V✓ O - O i V---n--------- C' - - - Str et and A"t.No.,or Ply Boz No:--- I � -------'-�'� (t Stree and`ffpt•No.,or PB Box No. City State,Z/P+4® I Ciry Sf e,ZIP+4® - ix rz 9 �✓Z C Aj d 2/ 4'd�l r. Al Y t S.2 I I TOWN OF SOUTHOLD C2� ZONING BOARD OF APPEALS i SOUTHOLD, NEW YORK s AFFIDAVIT ,c OF J In the Matter of the Application of: POSTING r MC- Der �,oh 'I" � D � .� rry 1 r�' (Name of Applicants) COUNTY OF SUFFOLIe~-- STATE OF NEW YORK I, r 1,•q ; D D . l D P C 'L residing at C(/I'C New York, being duly sworn, depose and say that: I am the ( ) Owner or X) Agent for owner of the subject property On the day of / A )( , 20 tl(,I personally placed the Town's Official Poster on subject property located at: ) il O /a/ M q ?'t 1 fi c� C ►---IN I r• 2 The poster shall be prominently displayed on the premises facing each public or private street which the property involved in the application or petition abuts, giving notice of the application or petition, the nature of the approval sought thereby and the time and place of the public hearing thereon. The sign shall be set back not more than 10 feet from the property line. The sign shall be displayed for period of not less than seven days immediately preceding the date of the public hearing of (Owner/Agent Signature) Sworn to before me this c d Day of , 20 ks 61A n CONNIE D.BUNCH (Notary Public) Notary Public,State of New York f4o.01 BU6185050 ®uafified in Suffolk County Commission Expires April 14,2�9 Postal _ 'Postal AIL D . ■ , t3 . ■ EC ElomesticMail 0171yDomestic Will OWY m C � , QtJ 10 r ; i ` I ,So tG�20}; 'r H'( 1 it971 t r IlLn ka L 3 :a U .m Certified Mail Fee $5.3fl y„((C1,7� m Certified Mail Fee 7vr, g '��r,a_.71 Er $5.3i I 71 Extra Services&Fees(check box,add fee e$�pr� te) r•.•�'+ .':�(;_'E4 Extra Services&Fees(check box,add fee �prlete i ❑Return Receipt(hardcopy) $ �r't,F,i C q.J ru ❑Return Receipt(hardcopy) $ -._ 0 r1 a ("�t ❑Return Receipt(electronic) $ IJ•tJ�I ,/ Postmark <� " p ❑Return Receipt(electronic) $ Postmark F + r e p ❑Certified Mall Restricted Delivery $ $I I.1 Il i p ti9re I I l7 ❑Certified Mail Restricted Delivery $ j rf I'll ❑Adult Signature Required $, I I t tI t iJ.� y !' C3El Adult Signature Required ❑Adult Signature Restricted Delivery$ L14 7�; El Adult Signature Restricted Delivery$ O Postage $CI.7v a� v: •'ir(�ty � Postage T IIPos V e and Fees 4 .„ �f ru T It1 os a • e and Fees tIG- e� 02 ru �r fu $ 16. Sent To CLt �r h I e r -s---- ® l--- ► c c o o a � Sire endAn t.Wo. --P--B1to'x�o. I4 _ _ ie h�^5-'�1------�!__�'_-C.C..�--------------------- - v_P 1 1 �fiee(anndf.IVo.,pc pDo C+ § - Cf S -- ZIP+4av(/r� ZIP+4 Postal, _ D' D" DotheqUo Mail Only co QU 16Y rr rY.l WA L U �...� Certified Mail Fee e Er $_+.3CI 0971 Extra Services&Fees(check box,add lee asr�oe)'e ;a 19 rU ❑Return Receipt(hardcopy) $ T. C I] ❑Return Receipt(electronic) $ $Li.,l'l0I-tl�Q Postmark O ❑Certified Mall Restricted Delivery $ 1 I I"Ii i a G HOre,// =1 []Adult Signature Required $ j'f`, ❑Adult Signature Restricted Delivery$ '+ •�� E-3 Postage $11,78 1 rU Tokal�1 T?!V a and Fees fl•61'•`_+7 2�126 $ru Sent T J�ti Icrh � ` - --- - Street a dApt.No.,o o IVo f = ti Vy �1 �; St ,ZIP+4 , c6MPLETE THIS / COMPLETE ON ■ Complete items'1_2 `and 3. A. Signatu R Print your name and 2ddeess on the reverse ❑Agent so-that we can return the card to you: X 0 Addressee ■ Attach this card to the back of the mailplece, B. Re e'ved b Printed Name) C. Date of Delivery or on the front if space permits. e e' i. Article Addressed to: D. Is delivery address different from item 17 O Yes If YES,enter delivery address below: ❑No I I V t Svr✓i�'o .l 'r ��v✓h C1� � +�s' Dlfr�vc � v ° r1 V I�IIIIII IIII LI I III III I III III 3. Service Type ❑Priority M611 Express®i I I II I III II III ❑Adult Signature ❑Registered MailTM ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted ❑Certified Mali@ Delivery 9590 9402 8639 3244 3841 10 ❑Certified Mail Restricted Delivery Delivery ConfirmationTM ❑Collect on Delivery 11 Signatu re,.Confirmation 2. Article Number(transfer fiom serVice label) 0 Collect On Delivery Restricted Delivery Restricted Delivery ' , ❑.Insured Mail; , . , 7022 2 410 0 2' 3 9 3i5 B 4:9 9 glnsureif Mali Restricted Delivery' '(over$500)'. . . . PS Form 3811,-,lUiy 2=PSN 7530-02-000-9053 --- -- Domestic Return Receipt I.-.�.-.-gym.- M y i r.(:..:•.. \ I SENDER: G*WPLETE THIS SECTION ON DELIVERY • TE THIS SECTION A. Sign u7:� ` ■ Complete_items 1,2,and 3: nt W' Print your name and address on the reverse ❑Addressee ` so that we can return the,card to you., B. eC by(Priri a 6me) C. Date of De�llve/ry ' ■ Attach this card to the back of the mailpiece, S_[ _2L or on the front if space permits. ❑Yes r 1. 0.'Is delivery address different from item Article Addressed.to: 1? 0•,U��� � If YES,enter delivery address below: [I No jr C) t IL .,� 3. Service Type J L r ❑Priority Mail E press® J v" ���1,,,1 II I II I IIII I III ❑Adult Signature Restricted Delivery ❑`Registered Mai Restricted IIII I I�I�IIIIIII I III II Certified Mail@ Delivery Confirmation- 9590 9402 8639 3244 3841 41 ❑Certified Mail Restricted Delivery •. ❑Signature -Collect on Delivery ❑Signature P61vfriattori' 1[3❑Collect on Delivery Restricted Delivery Restricted Delivery _ q_n+ilo:w�,rfier_[Traricfarfrnm caniiralaHPl) ❑Insured Mail 7 0 22 2 410 0002 3935 8 4 8 2 p Ins(ovreds o1 l Restricted Delivery R■ pomesue Return net elpt I Form'381.1'i,July 262 PSN 7530.02 000=9053 i �.- • COMPLETE SECTIONON SEN■ - • A. Sig ure I Complete-iterrls.1.12,and 3: QA tTAgAgent ■ Print your name and address on the reverse � ❑Addressee so that we can return the card to you. e, by by(Printed N�—O�Pao � e) Date of Delivery ' 10 1,Attach this card to the back of the mailpiece, L %O c� -`9 or on the front if space permits. 1. Article Addressed'to: D. Is elivery address different.from Item t? ❑Yes If YES,enter delivery address below: p No Irowh 0 � �17 w h C/eriT S O pd l'O• r� ' 3. Service Type ❑Priority Mail Express® IIIIIIIII I'll IIIIIIIIII I I I I III I II I II II IIII III ❑Adult Signature Cl Registered Mail ❑Adult.Slgnatue R Restricted Delivery ❑Registered Mail Restricted Ma . Certified il®„ Delivery- ❑Certified Mail Restricted Delivery 0 Signature Confirmation*"' 9590 9402-8639 3244 3841 34 ❑Collect on Delivery 0Signature Confirmation ❑'Collect on DeliveryRestricted Delivery Restricted Delivery 2. Article N�iim er $p�e 0 Insured Mail 0 0 0 2 3 9 3 5 4 ❑insured Mail Restricted Delivery (over$5001 •9053 Domestic Return Receipt PSlrorm$ , ' ,'Juy �-- i , • • • DELIVERY SENDER: • • , a Complete items 1,?,and.3: A. Sig re gent ■ Print your name and address on the reverse X v Addressee ; so that we can return the card to you. r Attach this card to the back of the mailpiece, Receii�€d by(Printed Name) C.Date of Delivery I or on the front if space permits. c 1. Article Addressed to: D. Is delivery address different fro item 1? ❑Yes If YES,enter delivery address below: 0 No �Sq1, 3. Service Type O Priority Mail Express@ II I IIIIiI IIII III I III I II I I ill III I II I III III I I III istered MalITM O0 Adult Adult-Slgnature Restricted Delivery 0Registered Mail Restrictedl Cj Certified Mail®, Delivery 9590 9402 8639.3244 3841 72 El Certified Mall Restricted Delivery. ❑signature Confirmation*"' ❑Collect on Delivery 17 Signature Confirmation ❑'Collect on Delivery.Restricted Delivery Restricted Delivery 2..Article Number(fransferfromservice_)abe1J 7 insured Mail 7022 2 410 0002 3935 8369 ❑❑r(over d,Ma I Re ict stred'Delivery +� Domestic Return Receipt *0 Form 3811,;July 2020 PSN 753.0-02 000,9053` SENDER: • •MPLETE THIS SECTION ON DELIVERY ■ Complete,items 1,2,and 3 A. Signature ■ Print your name and address on the reverse d"�- �t ❑Agent So that We Can return,the card to you. X` °'' 0 Addressee B. Received by(Prbfted Name) C. Date of Delivery ■ Attach"this card to the back of the mailpiece, s or on thefront if space permits. .�5 es 1 I 1. Article Addressed to: D. Is delivery.address different from-tern 9? ❑Yes If YES,enter delivery address:beloN . p No r I MAY 2 9 2026IV �{ )r 3. Service Type ❑Priority Mail Express® IIIIIIIII IIII IIIiIII I II I I III III I II IIIIII I III J13 Adult 7 Adult Signature Restricted Delivery [3 etered Mal TM ❑Reggistered Mail Restricted) O Certified Mail® Delivery ' ' 9590 9402 8639 3244 3840 80 ❑Certified Mail Restricted Delivery O Signature ConfirmatiohTM Collect on Delivery Restricted Delivery Restricted Confirmation O Collect on Delivery �Signature 2:Article Nuinber'(rrsrisferfrom seniice labgl) 4 C ry, ry ted Delivery- � 7 Insured Mail 7022 2 410 0002 3935 8352 p Insured Mail Restrieted Delivery ■ , — — (over$500) PS:Fort in 381 1,..haly 2020PSN 7530r02 000-9053 Domestic Return Receipt I I I 4 I I i I i i i )NI SUFFOLK COUNTY LEGAL NOTICE LEGAL NOTICE SOUTHOLD TOWN ZONING BOARD OF APPEALS THURSDAY,JU NE 4,2026 at 10:00 AM PUBLIC HEARINGS NOTICE IS HEREBY GIVEN,pursuant to Section 267 of the Town.Law and Town Code Chapter 280(Zoning), Town of Southold,the following public hearing will be held by the SOUTHOLD TOWN ZONING BOARD OF APPEALS at the Town Hall Annex Lower Level,54375 Main Road,Southold,New York 11971-0959,on THURSDAY,JUNE 4,2026: The public may ALSO have access to view,listen and make comment during the PUBLIC HEARING as it is happening via ZOOM WEBINAR. Additionally,there will be a linkto the Zoom Webinar meeting at http:// southoldtownny.gov/calenda raspx. 10-00 A.M.-KIMBERLY AND STEVEN BRUNT 48103 -Request a Reversal of the Building lnspector's October 27,2025.Notice of Disapproval,pursuant to Article II,Section 280-10 which states:a nonconforming lot(SCTM No..1000-68-3-8.3)shall merge with an adjacent conforming or nonconforming lot(SCTM No. 1000-68-3-8.4)which has been held in common ownership with the first lot at any time after July 1,1983. An adjacent lot one which abuts with the parcel for a common course of fifty feet or more in distance. Nonconforming lots shall merge until the total lot size conforms to the current bulk schedule requirements; located at:970 Salt Marsh Lane,Peconic,NY. SCTM No.1000-6B-3-8.3 and 1000-68-3-8A. 10:10 A.M.-KIMBERLY AND STEVEN BRUNI#8104-.Request for a Waiver of Merger petition under Article II,Section 280-10A,to unmerge land identified as SCTM No.1000-68-3-8.3 which.has merged with SCTM No.1000-68-34.4,based.on the Building Inspector's October 27,.2025,Notice of Disapproval;which states that a non-conforming lot shall merge with an adjacent conforming or non-conforming lot held in common ownership with the first lot at any time after July 1,1983 and that non-conforming lots shall merge until the total lot.size conforms to the current bulk schedule requirements;located at:970 Salt Marsh Lane,Peconic, NY. SCTM No.1000-68-3-8.3 and 1000-68-3-8.4. 10:20 A.M.-BLUE MARLIN REALTY,LLC-#B105-Request for Variances from Article XXIII,Section 280-124; Article XXXVI,Section 280-207A(1)(C);and the Building Inspector's December 8,2025 Notice of Disapproval based on,an application for a permit to demolish and construct a new single-family dwelling;at 1)less than the code required side yard setback of 15 feet;,2)less than the code required minimum combined side yard setback of 35 feet,3)gross floor area exceeding permitted maximum square footage for lot containing up to 20,000 square feet in area;located at:450 Blue Marlin Drive,(adj.to Shelter Island Sound)Greenport,NY. SCTM No.1000-57-1-26. 10:30 A.M.-LOUIS HUG_IRREVOCABLE TRUST/THOMAS HUG#8106-Requestfor.a Variance from Article III,Section 280-13A(6)(d)and-the Building Inspector's February 13,2026 Notice of Disapproval based on an application to construct an accessory apartment within a single-family dwelling at 1)more than the allowable 25%of the habitable space of the entire residence;located at 2100 Pike St.Mattituck,NY. SCTM No.1000-140-3-22. 10.40 A.M.-SCOTT KAU FMAN-#8108-Request for a Reversal of the Building Inspector's September 24, 2025 Notice of Disapproval based on an application for a permit to amend the construction of the.accessory structure for personal,conditioned use as an art workshop and studio,and antique storage with half bath; at:1)the proposed intent,as designed,does not constitute a permitted accessory use;located at;2050 Dignans Rd.Cutchogue,NY.(Adj.to Long Island Sound)SCTM No.1000-83-2-7.3. 10:50 A.M.-ANGELA LEVAS it 8109 Request for a Variance from Article)(XII,Section 280-116A(1)and the Building Inspector's December 31,2025 Notice of Disapproval based on an application for a permit to legalize an as built in-ground swimming pool at 1)less than the code required 100 feet from the top of the bluff;located at:5335 The Long Way(adj.to Long Island Sound)East Marion,NY. SCTM No.1000-21-5.13. 1:00 P.M.-NICOLE AND STEPHEN O'GRADY#8123-Request for a Variance from Article III,Section 280-15 and the Building Inspector's April 13,2026 Notice of Disapproval based on an application for a permit to legalize an as built shed accessory to an existing single-family dwelling;at:1)located in an area other than the code required rear yard;located at 315 Old Salt Road,Mattituck,NY. SCTM No.1000-144-5-20 1:10 P.M..-615 PIKE STREET,LLC-#8035SE-(Adjourned from May 7,2026)Request for a Special Exception pursuant to Article X,Section 280-45B(9)'of the Southold Town Code,and the Building Inspectors May 7, 2025,Amended May 22,2026 Notice of Disapproval to construct a commercial building with three(3)retail units,two of which are take-out retail,a second story accessory apartment and basement storage;.located at 615 Pike Street,Mattituck,NY.SCTM No.1000-140-2-21. 1:20 P.M.-VERADEANA PROPERTIES,LLC#8099-(Adjourned from May.21,2026)Request for a Waiver of Merger petition under Article II,Section 280-10A,to unmerge land identified as SCTM No.1000-59-6-23 which has merged with SCTM No.1000759-6-22,based on the Building Inspector's November 21,2025, Notice of Disapproval;which states that a non-conforming lot shall merge with an adjacent conforming or non-conforming lot held in common ownership with the first lot at any time after July 1,1983.An adjacent lot is one.which abuts with the parcel in common course of.fifty(50)feet or more In distance. Nonconforming lots shall merge until the total size conforms to the current bulk schedule requirements; located at 9555&9425 Soundview Ave.,NY.SGTM Nos.1000-59-6-23 and.1000-59-6-22. The Board of Appeals will hear all persons or their representatives,desiring to be heard at each hearing,and/or desiring to submit written statements before the conclusion of each hearing. Each hearing will not start earlier than designated above: Please note the last date to submit written:comments to this office will be the Friday prior to the public hearing. Afterwards,documents will not be accepted by this office,but can be submitted to the Board Members during the public hearing. If you have questions,please telephone our office at(631)765-1809,or by email:kimf@southoldtownnygov. Dated: May 21,2026 ZONING BOARD OF.APPEALS LESLIE KANES WEISMAN,CHAIRPERSON By:Kim E.Fuentes 54375 Main Road(Office Location) P.O.Box 1179,Southold,NY 11971-0959 ZBA Legal Notice June 4, 2026 Page 2 of 2 Tje,iuffolk�UMC$. See Proof on Next Page AFFIDAVIT OF PUBLICATION The Suffolk Times PO Box 1500, Mattituck, NY 11952 (518)730-4551 State of New Jersey, County of Camden, ss: I, Edmar Corachia, of lawful age, being duly sworn upon oath depose and say that I am an agent of Column Software, PBC, duly appointed and authorized agent of the Publisher of The Suffolk Times, a Weekly newspaper of general circulation, printed and published in Mattituck, Suffolk County, New York, designated by the County Clerk of Suffolk County as a newspaper of record;that the publication, a copy of which is attached hereto, was published in the said newspaper on the following dates. Publication Dates: • May 28, 2026 Notice ID: 5pTC0yHIDv01W1rpulfj Notice Name: ZBA Legal Notice June 4, 2026 Publication Fee: $200.52 Edmar &VAAh l Agent SHARONN E THOMAS-POPE NOTARY PUBLIC VERIFICATION STATE OF NEW JERSEY My Commission Expires January 23,2027 State of New Jersey County of Camden Signed or attested before me on this:05/28/2026 Notary Public Notarized remotely online using communication technology via Proof. ZBA Legal Notice June 4, 2026 Page 1 of 2 ov OFFICE LOCATION: �,�,OF SO�Iy� MAILING ADDRESS: r Town Hall Annex ,`O 1 P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (c Main Rd. &Youngs Ave.) 41 Southold,NY 11971 G ANc Telephone: 631 765-1938 AoD'of COW, LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: Leslie Kanes-Weisman, ZBA Chairperson R'ac&jed Members of the Zoning Board of Appeals MAC 119 jab Cc: Julie McGivney, Assistant Town Attorney Zoning Board of Appeals From: Heather Lanza, AICP, Planning Director LWRP Coordinator Date: May 18, 2026 Re: LWRP Coastal Consistency Review ZBA File Ref. No. #8123 O'Grady, Nicole and Stephen, SCTM#1000-144.-5-20 This application is a Request for a Variance from Article III Section 280-15. The Building Inspector's April 13, 2026 Notice of Disapproval based on an application to legalize an as-built shed accessory to an existing single-family dwelling at 315 Old Salt Road, Mattituck, NY (SCTM#1000-144:5-20) The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is a Minor Action and recommended as EXEMPT from LWRP review pursuant to: Chapter §268-3. Definitions. MINOR ACTIONS item "f" which states: F. Granting of individual setback, lot line and lot area variances, except in relation to a regulated natural feature or a bulkhead or other shoreline defense structure or any activity within the CEHA. The action for the as-built shed accessory is an individual setback not in relation to a regulated natural feature or other shoreline defense structure and is not within the Coastal Erosion Hazard Area (CEHA). The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. 2 j- COUNTY OF SUFFOLK a. - rurA(kysr-7-AJ EDWARD P.ROMAINE SUFFOLK COUNTY EXECUTIVE us�T ) DEPARTMENT OF ECONOMIC DEVELOPMENT AND PLANNING SARAH LANSDALE MAUREEN GETCHELL COMMISSIONER RORY WHELAN CHIEF DEPUTY COMMISSIONER DEPUTY COMMISSIONER 1 Received May 4, 2026 MAY ®4 ?0Z6 Town of Southold Zoning Board of Appeals 53095 Main Road P.O. Box 1179 Southold,New York 11971 Attn: Leslie Weisman, ZBA Chairperson Dear Ms. Weisman: Pursuant to the requirements of Sections A 14-14 thru A 14-25 of the Suffolk County Administrative Code, the following application submitted to the Suffolk County Planning Commission is to be a matter for local determination as there appears to be no significant county-wide or inter-community impacts. A decision of local determination should not be construed as either an approval or disapproval. Applicant Municipal File Number Dunning, Susan Juky 8114 O'Grady,Nicole & Stephen j� 8123 Clous, James A,,,1 8124 Very truly yours, By Victoria Malvone Joseph E. Sanzano, Planning Director Division of Planning and Environment JES/vm H.LEE DENNISON BLDG■ 100 VETERANS MEMORIAL HWY,2n°FI■P.O.BOX 6100 ■ HAUPPAUGE,NY 11788-0099 ■ (631)863-5191 BOARD MEMBERS ��OF SOUr "Southold Town Hall Leslie Kanes Weisman, Chairperson ,`O 01 0 53095 Main Road•P.O. Box 1179 Patricia Acampora Southold,NY 11971-0959 Robert Lehnert, Jr. Office Location: Nicholas Planamento G'�c► • �O� Town Annex/First Floor Margaret Steinbugler C�U(� 54375 Main Road(at Youngs Avenue) Southold,NY 11971 http://southoldtownny.gov ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631)765-1809 LEGAL NOTICE SOUTHOLD TOWN ZONING BOARD OF APPEALS THURSDAY, JUNE 4, 2026 at 10:00 AM PUBLIC HEARINGS NOTICE IS HEREBY GIVEN, pursuant to Section 267 of the Town Law and Town Code Chapter 280(Zoning),Town of Southold, the following "IN PERSON" public hearing will be held by the SOUTHOLD TOWN ZONING BOARD OF APPEALS at the Town Hall,63096 Main Road, Southold, New York 11971-0959, on THURSDAY, JUNE 4, 2026: The public may ALSO have access to view, listen and make comment during the PUBLIC HEARING as it is happening via ZOOM WEBINAR. There will be a link to the Zoom Webinar meeting at http://southoldtownny.clov/calendar.aspx. 1:00 P.M.—NICOLE O'GRADY-#8123- Request for a Variance from Article III, Section 280- 15 and the Building Inspector's April 13, 2026 Notice of Disapproval based on an application for a permit to legalize an"as built"shed accessory to an existing single-family dwelling; at: 1) located in an area other than the code required rear yard; located at: 315 Old Salt Rd., Mattituck, NY. (Adj. to James Creek) SCTM No. 1000-144-5-20. The Board of Appeals will hear all persons or their representatives, desiring to be heard at each hearing, and/or desiring to submit written statements before the conclusion of each hearing. Each hearing will not start earlier than designated above. Files are available for review on The Town's Weblink/Laserfiche under Zoning Board of Appeals(ZBA)\Board Actions\Pending. Click Link: http://24.38.28.228/WebLink/Browse.aspx?id=935072&dbid=0&repo=TownOfsouthold If you have questions, please telephone our office at(631)765-1809, or by email: kimf@southoldtownny.gov. Dated: May 22, 2026 ZONING BOARD OF APPEALS LESLIE KANES WEISMAN, CHAIRPERSON By: Kim E. Fuentes 54375 Main Road (Office Location) 53095 Main Road (Mailing/USPS) P.O. Box 1179 Southold, NY 11971-0959 i Town Hall Annex, 54375 NYS Route 25 Q P.O.Box 1179 � ^i Southold, New York 11971-0959 � ® "� Fax(631) 765-9064 ��l j ZONING BOARD OF APPEALS DATE: May 4, 2026 RE: INSTRUCTIONS FOR PUBLIC HEARING Dear Applicant; The June 4, 2026 Zoning Board of Appeals Regular Meeting will be held BOTH in person in the Town Hall Meeting Room at 53095 Main Road, Southold AND via video conferencing(Zoom Webinar), and a transcript will be provided at a later date. The public will have an opportunity to see and hear the meeting live, and make comments. Below;please see instructions required to prepare for the ZBA:public hearing which includes: PLEASE READ CAREFULLY. 1. Yellow sign to post on your property a minimum of seven(7) days prior to your hearing, to be placed not more than 10 feet from the front property line (within your property) bordering the street. If you border more than one street or roadway, an extra sign is supplied for posting on both street frontages. Posting should be done no later than May 27, 2026.To avoid weather damage to your sign please affix it to a sturdy surface such as plywood. If your sign is damaged please call the office and we will provide you with another-one. Prior to your public hearing, members of the Board of Appeals will each conduct a personal inspection of your property. If a Board member reports that there is no signage visibly on display as required by law, your scheduled hearing will be adiourned to a later date to ensure compliance with Chapter 55-1 (B) 1 of the Town Code. 2. SC Tax Map with property numbers. 3. Legal Notice of in person meeting,as well as video conferencing. Instructions for participation will follow, and will,be posted on the Town's Website under the meeting date, and the Legal Notice section of Suffolk Times Newspaper. 4. Affidavits of Mailings and Posting to be completed by you, notarized, and returned to our office along with the mailing receipts and green cards by May 27, 2026, verifying that you have properly mailed and posted. Please attach a photograph of the posting on your property with your affidavit of posting. 5. Instructions for Laserfiche/Weblink to view application. MAILING INSTRUCTIONS: Please send by I SPS'?C'ertified• Mail; R'eturn :iReceipt the following documents to all owners of property (tax map with property numbers enclosed) vacant or improved, which abuts and any property which is across from any public or private street. Instructions for ZBA F's.;'„c Hearing Page 2 Please mail documents to the legal mailing'address. (as on file with Southold Town Assessors Office) Mailing to be done by May 18, 2026. a. Legal Notice informing interested parties of meeting being conducted IN PERSON and via video conferencing. (Enclosed) A WEBLINK to the meeting will be provided on the Town's Website under the date of the meeting. b. Your Cover Letter which should include your contact information, date and time of hearing, procedures for submitting written comment via email or USPS to our office. Recipients should be able to contact you for additional information. Furthermore, if recipients need to contact the ZBA staff,they may telephone 631-765-1809 or email us at kimf@southoldtownny.gov or elizabeth.sakarellosgtown.southold.n�us c. Instructions for Laserfiche/Weblink to view all pending applications. (Enclosed) Link to view pending applications: http://24.38.28.228:2040/weblink/Browse.aspx?dbid=0. d. Survey or Site Plan depicting "as-built" and proposed improvements requiring ZBA relief. The Town's Laserfiche/Weblink files provides both location addresses and mailing addresses in their current Assessment Roll listing. (See Link Below). Also,the Town Assessor's Office can be reached at 631-765-1937. Contact us via email or by phone if you need further assistance. TownOfSouthold>Assessors >Assessment Books/Tax Rolls> https://southoldtownnv.gov/DocumentCenter/View/11008/tentroII2025-1 IMPORTANT}INSTRUCTIONS 3F t ., � .;l, ,t Scan and email the +LISPS+mailing receipts", n,,sigpature cards and affidavits to 1c MMP ,96utholdtownny ett gov, ands PROMPTLY I'7,S'PS�MAIL th RIGINAI S to theTown ofS.outhold. ZBA,rP,.O. Box1�179; Sou Two thol'd ;W. NeYM`11971 Please note that without your mailing receipts, the ZBA will be prevented from conducting your hearing,pursuant to Chapter 55 of the Southold Town Code and New York State Law. Please note that you or your representative are required to attend. If you or your representative are not present, the hearing will be adjourned to the next available hearing date. Please be reminded that New York State Law requires the ZBA to follow the above specific policies. If for any reason, you are unable to prepare for your public hearing as instructed, please let us know. ***PLEASE NOTE*** : THE LAST'DAY'TO SUBMIT WRITTEN DOCUMENTS TO THIS OFFICE FOR THE BOARD MEMBERS WILL BE THE FRIDAY PRIOR TO THE PUBLIC HEARING. AFTER THAT, NO DOCUMENTS WILL BE ACCEPTED BY THE OFFICE BUT CAN BE SUBMITTED TO THE BOARD MEMBERS AT THE PUBLIC„HEARING: Kim E. Fuentes—Board Assistant u- TI E 0 "m HEARIi4o The following application will be heard by the Southold Town Board of Appeals at Town Hall, 53095 Main Road, Southold "he application will ALSO be available VIA ZOOM WEBINAR - Follow link - httpo.//Southoldtownny.gov/calendar.aspx 4AMEmm O ' GRADY, NICOLE #8123 SCTM #m. I 000= 1 44=5=20 VARIANCE: LOCATION r--,EQUESTm. LEGALIZE "AS BUILT" ACCESSORY SHED DATE : THURS. , DUNE 45 2026 1 :00 PM You may review the file(s) on the town's website under Town Records/Weblink: ZBA/ Board Actions/ Pending. ZBA Office telephone (631 ) 765-1809 kA OLk 02-CA09 BARGAINAND SALE DEED with Covenant against Grantors Acts THIS INDENTURE, made the day of July,2025 delivered August 12, 2Q25, ,BETWEEN KATIE, LAUFER, as Trustee of the, Thomas and Rosemary McDermott Irrevocable Trust u/a dated December 20, 2022, 315' Old Salt Road, Mattittick,,NY 11952,party of the first part and;, NICOLE 01GRA0Y and STEPHEN 0%]RADY, 8301 Bradford Avenue, 'Westfield.,1VT07 'party, of the second part.. WITNESSETH, that the party of the first part in consideration of ten dollars and other valuablo consideration paid by the party of'the second part, does hereby giant and release unto the party of the second part, the heirs or successors and.assigns of the party of1he second partjorever ALL. that- certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the (see attached schedule "A") I Being the same premises described in the deed to the.parties of the,first'part herein dated December 20,2022 recorded July 14,2023 in Liber 13209 Page 587 in the Office of the County Clerk, County of Suffolk. Suffolk Tax.'.Map#1000-144.00-05.00-010.000 'TOGETHER with all right, title and interest,,if any, of,the.party of the first part of, in, and to any streets and roads abutting the above, described premises to the, center lines thereof; TOGETHER with the appurtenances and all the estate and tights, of the party of the first part in and to said promises;,TO HAVE AND TO HOLD the premises herein granted unto the party of the second part,the heirs or successors and assigns.of the party of the second,part forever. AND the party of the first part covenants that "the party of the flist part has not done.or suffered anything whereby the said premises have been encumbered`in any way whatsoever, except as aforesaid. AND the party of the first part, in compliance with Section 13 .of the Lien Law, covenants-that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as la trust fund to be applied.first for the purpose of paying the cost of the improvement and will apply -same first to the payment of the cost of the improvement before using-any part of the total of the same for any other purpose. The word "party" shall be construed as.if it read "parties" whenever the sense of this`indenture,so requires. -IN WITNESS WHEREOF,the party ofthe first part.has duly executed this deed the day and year first above written. IN PRESENCE OF: KA IE LAUF STATE OF NEW YORK ) COUNTY OF SUFFOLK ) On the 29ffi day of July,, 20.25 before me, the undersigned, personally .appeared. KATIE LAUFER, personally known tome or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) :is (are) subscribed .to the within. instrument and acknowledged to me that he/she/they-executed the same in his/her/their capacity(ies), that by his/her/their signature(s) on the instrument, the individual(s) acted, executed the instrument. Notary Public DAVID J.JANNUZZI NOTARY PUHUC,STATE OF NEW YORK Registration Nm 021A6052685 Qualified in Suffolk County Commisrion'Expires February 13, Po box zz �o hD18 11 q'i FIDELITY NATIONAL TITLE INSURANCE COMPANY POLICY NO. :7404-020409 SCHEDULE:A AMENDED 7129126' ALL that certain plot, piece or parcel of land, situate, lying and being,in the Town of Southold,County of Suffolk.and State of New York';known and.designated as Lot 8,on a certain map entitled, "Map of Salt Lake Village", and filed in,the Officeof the Clerk of the County of Suffolk on May 10,1940 as Map No. 1310; bounded.and'described as follows;: BE at a monument on the Southerly side of Sailors,Needle which point is the division line between.Lots 8 and 9 on-the aforesaid map;: RUNNING THENCE along,the division line between Lots 8 and 9 on the aforesaid map,South 10 degrees 55 minutes 00 seconds East, 112.00'feet; THENCE along Village Dock:and Boat landing and along the arc of a curve bearing,to the left having;aradius of 140.00 feet a length of 54:86 feet to.land.(now or formerly)of Salt Lake Property Owners Association; THENCE:South 79 degrees 05 minutes'00 seconds West, along Last mentioned land 84:73 feet to the Northeasterly side of Old Salt Road; THENCE along the Northeasterly side of Old Salt.Road the following two:(2)courses'and distances; 1.Along the arc of a curve.bearing to the left having a radius of 38.00 feet a length of 25.26 feet; 2..North 10 degrees 55,minutes 00 seconds West, 109.00`feefto the arc connecting the Northeasterly side of Old Salt Road with the Southerly side of Sailor's;Needle,which arc has a.length of 62.23 feet; THENCE along the arc of a curve bearing to the right connecting the northeasterly side of Old-Salt Road and the southerly side of Sailor's:Needle having a radius of 40.00 feet and a length of 62.83 feet; 'THENCE along the Southerly side of Sailor's.Needle North 79 degrees 05 minutes OO seconds East, 84.50 feet to the point or place of BEGINNING: END OF SCHEDULE'A Copyright American Land Title Association. All rlahts reserved. nAlLaicAN I.ANU T_ITIL \\NKIAI IIIM The use of this Form(or any derivative thereof)is restricted to ALTA licensees and ALTA members in good':standing as of the date of use. All other uses are prohibited. Reprinted under license from the American Land Title Association. ALTA Owneea Policy of We Insurance.2021(031OW024) Printed: 08.0i3:25®01 21 PM NY-FT FRVH-01030.431004=SPS-27512-1-25-7404-020409, FOR COUNTY USE f. ;S):,www_orpsstati s C1. SWIS Code 14 t 7 , 3 , 8 , B I 9 1 New York State Department;of ca. note Deed,Reco dad 10 / 21/ 20.25 Taxation and Finance heath Day .Year ONice:bf Real Property T6k Sen>l6es C3- Book L1,313 111 3 I C4-'page L 1 1'7 , 01 0.I RP_.5217=PDF Real Property Transfer.Report JIVIO) PROPERTY INFORKRTIONI 1.Property. 31 S 'Old Salt Rcyad. Location __----:_..:__....::.:.:....I .. . ' -STnaaT..WMe2R Mattituck i1952 .-.' cult OR K1wN"..—.,,....—,.........«........._—. —.,.-j.AuP.. 2_Buyer 0'Grady' Nicgle Name ^^ - --- LAST NAMEICOMPANY FIRsT'mm%' O'Grady Stephen .... LAST NAVGCOWANY - FIRST NAME 3.Tax Indicate Where future Tax Bills are to be sent Bilifng if outer than buyer.address(at bottom a form) Address LAST NAMEJcouvnnY '�''' rlRrsi Namr•. ""'-' 'STACHT NLNAL=k-1)NAME CfrY OR 1"0W4 S fATF. ZIP CODE 4.Indicate the number of Assessment 1 - f^^•I PaR of Parcel- (Only if Part of-a Parcel)Check-as'they apply- RON parcels transfarred'on,the deed #of parcels OR L•.-1 ALA.Planning 0oard.with Subdivision Authority Exists S.Doed _. X OR 0..43 48_.Subdivision Approval was.Required for Transfer Property •"W"W AYF.T •DePT'If •ACRrs {� Size AC.`Parcel Approved for Subdivision with(Nap.Provided L J Lau'`,'2r, .a.5 Trustrera '$.Bolter �•L•AyT NAMI9GOMi`ANY ''7�,rjTTST•N+AMMEm '-- Name .�.._.`Mf AME ,...._......,..... 1.0.4T NAN!PJCOOA?ANY / FFnST NAMG '.T.Select the description which moat accurately,describes the Chock the foxes below tie they apply: use of the property,atthe'timo of sale; 8.Ownership Type'la Condominium A.One.Family Res160.nt'ia) 9.New Construction on a Vacant Land U 'IOA.Property Located within an Agricultural District 108.Buyer received a dtedasure noltce indicating that the property is in an ❑ -AgAcultural District SALE INFORMATION 15,Check;one ormore of theme conditions oa.appfieob(e..to,transfer, A:Sale Between Relatives or Former Reld..lves 11,Sale Contract Date O Z/0 9/:2 0 2 5 S.Sale laniWoen Related Companies or Partners In Business. - 0.tine of the.Buyers is also a Seller O a/12/2 02 5 D.Buyer or Seller is GcverpniorA r+gen0y or Lending institution 12.pate of 9alerTra rioter E.Deed Type'.oi Warranty nr Bergaln and Sale(Specify Below) F_Sale of Fractional or-Less than Foo Intomat(Specify Below) *43.Full Sale Price 1 r 7,50,00 0'00 G.Significant.Change in Property Between Taxable Status and Sale Oates -^---� H.Sale of BuslnosA is.fnGuded in Sale Price (Full Sale Price ioLthe total amount paid forthe property including personal property. 1. Other unusuai'factora Affecting Sale Price(Specify Below) 'rhis payment may be in the form Of cash,other property or goedg,or the assumption of J.None mortgages or other obfigations.)Pjanse round to the nearest whole doffar amoral. Comment(•)on Canditlon: i4.Indiadta,the_value of personal ,property Included In the Sale 0_.001 ASSESSMENT INFORMATION-Data should reflect the latest Final Assessment Roll and Tax Bill 18.Yoer of Assessment Rolt.from which information taken,('YY) 21 *17.Total Assessed'Vdlun, "7,10 o 116.Property.Class 210 _19_School District Hama 12 Mattitu4-_k-Cutr,h'c�gue. -20.Tax.Map IdantiRar(s)1Roli Idantiflor(s)(If more than four.attach Sheet with additional fdontlflerls)l �- .1000-144.00-05.00-020_000 C eRTIFICATfON I Certify that all of the items of Information entered on this form are true and Correct(to the bast of my knowledge and ballet)and 1 understand that the making of any willfut false statement of material fiat hereto Sul]ect me to thayt#y13.lpns_otthapenai.laa_rotative.to the making and filing of false Instruments. NELLER S)GNATLRB 8UYER_(;Oj TAQT_WEORMATION (Enter infonnatlon Tor the buyer,Naga:Ir buyer,is,LLC,6ociely,association,rnrpomlien.joint stock ootnpany,eata,n or �, enplythw'la not a )id`vIdUatagorA ar fidy0ary,then a name and aontect hformation of an IndiviWal"sDonsible a p'aAy who cmi ilnawer qu'ifosiarw regarding the transter must pa entered.Typo or print clearly.) �l• -A+r tJ.:k SxiNAlllnG - �/.� �r/"F�"e.•^ O'Grady Na_cale ----- -'LA9T NAMF — �R1kx'1'-NAME. ii JJj (/1 GA COnR /R-TEi.[Y14o NVM7ER{ —.A99 v.a rIGNA'r4iRC+ ._��.RC3 DATEI ..... -'"V'^' �j/!I�"L+�1�•5::+�..�+- /,t /� G O ��� •STHE[7 NVM[SEN •S TmcTN+.ME S � "•GITY OR UWN STATEl -zrl,conri 1�S1Y..1ER g.,E4,7�7C,C+fttif"X. 1 u a iegh Saridr.a f s, �"I.AST NAMF_ 'r'1RyT NAME I I r Iri AREA CODE _�- TQutPsaoNK NUMaCJi IE•':"PD w9) J r--7RDED Numberof'pages 4 10J21/,2., 1' B t 54:.06. PM, VINCENT, PULEO - -..•— CLERK OF 'This dOr.:lt�'t't�'nt xOM be piu�lic, SUFEOLIt. COUNTY `L DOO'013313 P 700 Doadl Morfgae a Instrument Deed.J Mortgage Tax Stamp Reaordirarq J Filing Stamps Page%Filing Fee Mortgage Amt. 1;Basic Tax Handling .20, 00 :2, Additional Tax TP-684 5'-0o StibTotal Notation 0.00 fipac.rAssit. or s M217(County) 5-00 SubTofal 5.0.00 Spao.AAdd:- EA-6217(State) 125.00 TOT,mTG,TAXI R.P.T,S.A. 200`.00 Dual Towh bual County Held for Appointment ?pointment Comm.of Ed. 5'. 6tt Transfer"fax; 0-00 ' Mansion Tax 0-0"0 Affidavit ` Ct?rtified co Q.00 The property'coveted by this mortgage is: pY or sail bd 'improved by a one: `bF"tv,+a NYS-Siurcharge 15. 00 . 345.00 familydvoellino only, Sub Total:....: yts.. orW,; ...... ...T t)tirer 395.00. Grand,Totaf - IfNO,set appropriate tax clause.6n Page# of this instrunient.. Dlst. Section Block- kot 5 Go►nrri xr ty Prdservation Fund z50a0a70 - 1,750;000.'00 �02I Property T Cotzsi.deratiQn:'�.st7otint �dX58NicQ P S R LPR.A $ 3B,750.00 �4gQncy 10fir2025 C-PF Tkx I}itL . Verification p 584 Prepaid Improved x a is a sons argesi a eases w PFooe hers. ai tng Tess RECORD&RE URNTO; Fidelity 'Nati.onal Title — Riverhead, Nr TD 10 24. commeToe Drive. Riverhead NY 11901 TRH. TD. Mailto:. 'Vncent,Puleo,Siffiolk County.Clerk 71, Title Company-Information 310 Center 10 ve, Rive&ead, NY 41901 Go.Name www,suffo°koountyny.goviolerk T'WO# Suffolk. ounty ecor ing n orsement Page This page.forrns park D[ther attaohed: DE® tnadt: by, (sPECIFYTYPE:OF INSTRUMENT) The;prerruses led in SUFFOLK:GOUNTY, NEW YORK TO to the TOWNof SOUTHOLD Inth VILLAGE. c+t FiA4�tt.tT.of.. BQXES6.TMRU 4 MU�',BETYPEO OR:PRINTED M BLACK.INK ONLY PRIORJO PECORDINC-OR Pti.l#0. I IIIIIII IIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII I(IIIII IIIII IIIII IIII IIII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 10/21/2025 Number- of Pages: 4 At: 8:5.4:06 PM Receipt Number: 25-013.6666 *ELECTRONICALLY RECORDED* Transfer Tax Number: 25-08400 LIBER: n00013313 PAGE: 700• District: Section: Block Lot: 1000 144.00 05.0.0 020.000 EXAMINED AND CHARGED AS FOLLOWS Deed Amount $1,7501000.00 Received the Following Fees. For Above Instrument Exempt Exempt Page/Filing :$20. 00 NO� Handling $20.:00 NO COE $5. 00 NO NYS SRCHG $1.5_.00 NO Notation $0.00 NO- Cert.Copies $0.00 NO RPT $200.00 NO Mansion Tax $0.00 NO EA-CTY $5.00 NO EA-STATE $125.00 NO TP-584 $5.00 NO Comm.Pres $38,750,.00 NO Comm.Pres 'Fund $31.,000.00 NO Comm.Housi:ng Fund $7,750.00 NO ` Transfer Tax $0.00 NO Transfer Tax Number: 25-084.00 Fees Paid $39,145.00 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL Vincent Puleo County Clerk, Suffolk County TOWN OF SOUTHOLD Rental Permit 1406 Owner: Stephen & Nicole O'Grady Occupied as: Single Family Dwelling Located at: 315 Old Salt Rd Mattituck 144.-5-20 Maximum Permitted Occupancy: 6 Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection. Issued: 12 19 2025 J40WI Expiration: 12/19/2027 ce a forcement MI 0 . CD PL $. CD This Notice must be posted by the main entrance at all times o m BOARD MEMBERS �Ig$Q(��y Southold Town Hall Leslie Kanes Weisman,Chairperson ��� Ofa , 53095 Main Road • P.O.Box 1 179 Patricia Acampora Southold,NY 11971-0959 Robert Lehnert,Jr. Office Location: Nicholas Planamento • y0 Town Annex/First Floor Margaret Steinbugler `�C�rJ 54375 Main Road(at Youngs Avenue) Southold,NY 11971 http://southoldtownny.gov ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel.(631)765-1809 April 20, 2026 Heather Lanza, Town Planning Director LWRP Coordinator Planning Board Office RCGDD Town of Southold Town Hall Annex APR, 2.1 2026 Southold,NY 11971 SUU i Hein TGVc'IJ PLAN NC J;,2D Re: ZBA File Ref. No. # 8123 — O'Grady, Nicole & Stephen Dear Sir or Madam: We have received an application legalize as built shed accessory to an existing single family dwelling. A copy of the Building Inspector's Notice of Disapproval under Chapter 280 (Zoning Code), and survey map, project description form, are attached for your reference. Your written evaluation with recommendations for this proposal, as required under the Code procedures of LWRP Section 268-5D is requested within 30 days of receipt of this letter. Thank you. Very truly yours, Leslie K. Weisman Chairperson)) ll By: Encl. Site Plan/Survey: Kennth Woychuck Land Surveying PLLC last dated April 6, 2026 Public Hearing Date: June 4, 2026 BOARD MEMBERS souryo Southold Town Hall Leslie Kanes Weisman,Chairperson ,�O �Q 53095 Main Road• P.O.Box 1179 PatriciaAcamporaic Southold,NY 11971-0959 Robert Lehnert,Jr. G Office Location: Nicholas Planamento `p y0 Town Annex/First Floor Margaret Steinbugler l�coum, 54375 Main Road(at Youngs Avenue) Southold,NY 11971 http://southoldtownny.gov ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel.(631)765-1809 VT1 04", April 20, 2026 Mr. Joseph E. Sanzano, Director I�I L(e Suffolk County Department of Planning P.O. Box 6100 Hauppauge, NY 11788-0099 Dear Mr. Sanzano: Please find enclosed the following application with related documents for review pursuant to Article XIV of the Suffolk County Administrative Code: ZBA File #: 8123 Owner/Applicant: O'Grady, Nicole,& Stephen Action Requested: legalize as built shed accessory to an existing single family dwelling; front yard setback of 16.9 ft Within 500 feet of: ( ) State or County Road (� Waterway (Bay, Sound, or Estuary) ( ) Boundary of Existing or Proposed County, State, Federal land ( ) Boundary of Agricultural District ( ) Boundary of any Village or Town Within one (1) mile (5,280 feet) of: ( ) Boundary of any airport If any other information is needed, please do not hesitate to call us. Thank you. Very truly yours, Leslie K. Weisman Z B A Cha' person By: - Encis. Site Plan/Survey: Kenneth Woychuk Land Surveying PLLC last dated April 6, 2026 . 1 Appendix A - County Referral Form Appendix A—Suffolk County Planning Commission Guidebook Suffolk County Planning Commission Submission Cover Form for Planning and Zoi-Ang Referrals Municipality: Town of Southold Hamlet: Mattituck Local Case Number: 8123 District: 1000 Section: 144 Block: 5 Lot:20 Local Meeting Date: 6/4/2026 Referral Name: O'Grady, Nicole & Stephen Public Hearing: W]Yes 0 No Referring Agency: Type of Referral: Planning Board or Commission l.r 61-239/A14-14 S.C.P.C. Regulatory Review ❑✓ Zoning Board of Appeals DMA Review- Request for Informal Input Town BoardNillage Board of Trustees F Attached Units Projects (Apartments) SEQRA Action: ❑EAF Coordination DDraft Scope ❑Draft EIS Final EIS ETindings Project Narrative - Brief description of application: legalize as built shed accessory to an existing single family dwelling Full Statement of Facts Includes: County Referral Form (Appendix A) Public Notice (if applicable) Local application form Completed Environmental Assessment Form along with other materials associated with the environmental review process- Including Draft EIS, Final EIS Local Planning Board, Zoning Board, Agency or Department report Project sponsor, applicant's or owner's name and mailing address For Subdivision Referrals must also include: Map name. The map shall clearly state the name of the subdivision and that the map is a preliminary or final map. Any map containing the words "sketch plan" will not be accepted. Duplicate subdivision names within a town or village will not be accepted. Condominium plans shall clearly indicate that the project is proposing a condominium form of ownership. Type of Action: Please check appropriate box below if action is located within the Suffolk County Pine Barrens Zone, within one mile of a nuclear power plant or airport or within 500 feet of.- . A municipal boundary, The boundary of any existing or proposed county, state, or federal park or other recreation area, • The right-of-way of any existing or proposed county or state road, • An existing or proposed county drainage channel line, • The Atlantic Ocean, Long Island Sound, any bay in Suffolk County or estuary of any of the foregoing bodies of water, The boundary of county, state, or federally owned land held or to be held for governmental use, The boundary of a farm located in an agricultural district. Please Check all thatApplies: Comprehensive Plan (Adoption or Amendment) Subdivision EISEQRA Only Zoning Ordinance or Map (Adoption or Amendment) Use Variance 1-1 Moratorium Special Use Permit/Exception/Conditional Use V/Area Variance Site Plan Code Amendment ❑Official Map Note: The above represents a summary of the required actions subject to referral to the Suffolk County Planning Commission.The provisions of GML and Laws of Suffolk County must be used to verify which actions are subject to referral and the related procedural requirements. Additional Application Information: Action Previously Referred to Suffolk County Planning Commission No es(If Yes Date ) Adjacent Municipality Notified (see NYS GM 39nn) �No es(If Yes Date ) Contact Information Municipality Contact Name: Leslie Kanes Weisman,Chairperson Department/Agency: zoning Board of appeals,Town of Southold Phone Number: 631-765-1809 Email Address: donnaw@town.southold.ny.us Applicant Contact Name: Eligio Lopez,North Fork Expedite Applicant Address: 36570 Main Road,Cutchogue,NY 11935 4/21f26„ 11:111AM File drop-Nextcloud-Suffolk County Cloud 41 File drop -I- New 00 Q Type Modified Please upload Referrals with a Completed Appendix A and all supporting documents within one PDF Upload files to Planning. Successfully uploaded files 0 #8123-O'Grady CoPI Referral.pdf + Upload hftps://nc.suffo[kcountyny.gov/s/6JMEAyKt27Szcap 1/1 Town of Sout 1 04/20/2026 ho��°f S°uTyolo 53095 Main Rd Southold, New York 11971 �o (631) 765-1802 0UNTI.N�31 Zoning Application Information File Number: 8123 Master Parcel: 144.-5-20 Assignment Code: 17NP Owner Name: Nicole O'Grady Location: 315 Old Salt Rd Print Key: 144.-5-20 Status: Pending Description: legalize as built shed accessory to an existing single family dwelling;front yard setback of 16.9 ft Notes: No AG No priors No Stop Work orders Ltrs-CoPI LWRP sent 4/20/26 DATES CoPL: Sand W: Decision Date LWRP: PB: Sent to LF: Trustees/DEC: Page 1 of 1 BOARD MEMBERS *0f so�jyo Southold Town Hall Leslie Kanes Weisman, Chairperson ,`O 01 0 53095 Main Road •P.O. Box 1179 Patricia Acampora Southold,NY 11971-0959 Robert Lehnert, Jr. cr, Office Location: Nicholas Planamento • �O� Town Annex/First Floor Margaret Steinbugler liYc�UIV l 54375 Main Road(at Youngs Avenue) Southold,NY 11971 http://southoldtownny.gov June 25, 2026 ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Eligio O. Lopez Tel. (631) 765-1809 36570 Main Road Cutchogue,NY 11935 Re: ZBA Appeal No. 8123 315 Old Salt Road, Mattituck SCTM No. 1000-144-5-20 Dear Mr. Lopez; Transmitted for your records is a copy of the Board's June 18, 2026 Findings, Deliberations and Determination, the original of which was filed with the Town Clerk regarding the above variance application. Before commencing any construction activities, a building permit is necessary. Be sure to submit an application along with a copy of the attached determination to the Building Department. 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 Sincere y, a Kim E. Fuentes Board Assistant Encl. cc: Building Department _ / i 1�� / / / \� N300.82 ,7 \-P ro 10, op, 29.3 01 01 10) 0 41, 10, 01 lS N9 Ak 0. .1ro 41 \ // N 298.B82 9 COUNTY OF SUFFOLK (9) N NOTICE K OUSTRICT NO. 1000 SECTION NO. E Real Property Tax Service Agency MAJNTBW4C--ALTERATION SALE OR Y 22 w E D STRIBLMON OF ANY PORT10N OF THE .12 TOWN OF SOUTHOLD I 300 Ce-',,,aw',k—&,�d vy 11901 S-FOLK COUNTY TAX MAP IS PROHIBITED M 144 A VVTrHOLrr WRITTEN PONW13N OF THE P ...... ...wl- REAL PROPERTY TAX SERVICE AGRCY 128 lu VULAGE OF D�SU Lk ry TOWN OF SOUTHOLD—BUILDING DEPARTMENT i yg Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 • Telephone 631 765-1802 Fax 631 765-9502 htt s://www.southoldtownny. ov y o1,9 P � ) � ) P ii Date Received APPLICATION FOR BUILDING PER For Office Use Only j j it PERMIT NO. Building Inspector i r ._. �.�. DEC Z 9 2025 i Applications:and forms must be filled outn their:entirety:Incomplete applications will not 6e accepted>.Where the Applicant'is not tl'e owner,an %"^ ii? i�ors t ,�F),.,.;'v gyp,.,¢ Own'er's Aiathorrzation form(Page 2}`shall be completed Date: OWNfR(S)OF PROPERTY Name: fi 4/ 1 C is GF + TM# 1000- /Li t.,t..— Project Address: f�' D a l 7- Phone#: 7 .L Email: Mailing Address: S q P� -c- f ✓9 0 C CONTACT PERSON Name: E/r Mailing Address: AA 4- 1 it/ Phone#: 3 (_ _ 1 - Email:e(o e-c.7-14 4 1 PA D'ESIGN`PROFESSI.ONAL INFORMATION Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION ' Name: j) i /�� Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure A dition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Other / $ !v o o Will the lot be re-graded? ❑Yes Colo Will excess fill be removed from premises? ❑Yes Cwo 1 PROPERTY INFORMATION Existing use of property: rI nl Intended use of property: c f l Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R t 0' this property? Nfes 0No IF YES, PROVIDE A COPY. *�Check Box After Reading: no owner/contractor/design professional Is responsible for all drainage and storm water Issues as provided by Chapter 236 of the Town Code. APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Building Permit pursuant to the Building Zone Ordhmmm of the Town of SouthoK Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings, additixrsr afteradom or for removal or demolition as herein described.The applicant agrees to comply with all appUable taws,ordinances,building code, Iwusbq code and regulations and to admit authorized Inspectors on premises and In buildings)for necessary Inspections.False statements made herein are punishable as a Class A mhuilmeaocr pursuant to Sactiotr 210AS of the Now York State Penal Lew. El/9/ 0 0 L'o Application Submitted By(print name): ;Authorized Agent ❑Owner Signature of Applicant: � 0 Date: STATE OF NEW YORK) SS11 COUNTY OF 5'U:FO V� ) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the ej (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 kno ledge and belief;and that the work will be performed in the manner set forth in the application file they Sworn before me this ( v day of 20 Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) j -{P h cvl 0 "64-Ly I, 1J; c lx 0`Gi•udw residing at_ 3 I s y I d If nd , MX"LIL,JUG -s do hereby authorize E 11510 to apply on my ehalf to a Town of Southold Building Department for approval as described herein.Owners Signatfire GAM W'V, SAIECM NOTARY PUBLIC,STATE OF NEW YORK A),L D '6>ru tLi,1 Registration No.02SA6407223 Print Owner's Name t Qualified In Suffolk County Commission Expires 05-18-20-421 2 ?a =1 S.C.T.M. N0. DISTRICT: 1000 SECTION: 144 BLOCK: 5 LOT(S):20 DISAPPROVAL MO / BOG 1V Y Z7`�,7 U.P. Oo y lP �19 V Y I Y�s- y� LOT 9 W.V.O W.V. k '6' LOT 8 ASpyglTpR�` SHOWER %4Y CONC. :'24:4':• � LIGHT POLE N n < w :;o � . yFo •O MON. CONC. Y cF 61, ::::::: S Q, O W ...co 11.6 ... 162g 00 ::: 1 STY FRM.::::::::::::::: 6 MON. cS; ;•;;;;;;;;DWELLING O 02 .� ....................... 3011 ��b, 7' Q W 00 Q zS L ,� OQ 72- 39' > �O U.P. 0 LAND NIF OF p O�j,oo SALT LATE PROPERTY �9 OWNERS aSSOCIATION R - 61 W.M. FEMA MAP#36103C0482H eFFECTIVE 09/25/2009 THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS AREA: 19,191 S.F. or 0.44 ACRES ELEVATION DATUM.* UNAUTHORIZED ALTFRA77ON OR ADD17ION T19 THIS SURVEY IS A WOLA77ON OF SEC77ON 7209 OF THE NEW YORK STA7F EDUCA77ON LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VAUD TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO 714E PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE 777LE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INS71TURON, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES, ADD17IONAL STRUCTURES OR AND 07HER IMPROVEMENTS. EASEMENTS AND/OR SUBSURFACE S7RUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE 77ME OF SURVEY SURVEY OR LOT 8 of NEVI CERTIFIED TO: STEPHEN O'GRADY; NICOLE O'GRADY; MAP OF: SALT LAKE VILLAGE P \A M' w 0 FIDELITY NATIONAL TITLE INSURANCE COMPANY; FILED: MAY 10, 1940 No. 1310 Y X SITUATED AT: MATTITUCK TOWN OF: SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC SUFFOLK COUNTY, NEW YORK tis 050882 JQ Professional Land Surveying and Design F P.O. Bog 153 Aquebogue, New York 11931 FILE _134 SCALE:1"=20' DATE:JULY 20, 2025 T PHONE (831)298-1588 FAX (631) 298-1588 N.Y.S C. NO. 050882