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Home My WebLink About#8147-Schaffer ZBA application V TOWN OF SOUTHOLD Received BUILDING DEPARTMENT JUL 1412026 SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL Zoning Board of Appeals DATE: May 15, 2026 AMENDED: July 14,2026 TO: Frank Gianelli (Schaffer) 1200 Youngs Road Orient,NY 11957 Please take notice that your application dated May 8, 2026: For permit to: construct additions and alterations to an existing single-family dwelling at: Location of property: 660 King Street, Orient NY County Tax Map No. 1000 - Section 26 Block 2 Lot 36 Is returned herewith and disapproved on the following grounds: The propos ft. lot in the R-40 District is not oermitted mrsuant to Article XXIII Section 80-124. which states lots measurin less than 20,000 s uare feet in total size require a minimum side yard setback of 10 feet. The construction has a minimum side yard setback of 3.5 feet Additionally, the construction is not permitted pursuant to Chapter 170 of the Southold Town Code and is subject to Historic Preservation Commission approval This Notice of Disapproval has been amended to reflect the revised site plan and plans last dated, 7110126. Authorized Signature Note to Applicant: Any change or deviation to the above referenced application may require further review by the Southold Town Building Department. CC: file, ZBA, HPC APPLICATION TO THE SO THOLD TOWN BOARD OF A @ AREA VARIANCE House.No. 460 Street lg�:Ia6r sT Hamlet OF-1'-0 T UL 14'2026 SCTM 1000 Section: 26 Block: Z Lot(s) 3 to Lot Size: Ra 'AAAWAeof Op I(WE)APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED BASED ON SURVEY/SITE PLAN DATED ( ) o W�.a-D 5 Gil A r-F�1�-- Owner s Mailing Address: F. C)' go$ 0V— �.N rt' N:�• l��l 5 7 Telephone: Fax: A. Email: OWlI^ � td.i(� GoM 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: for( ) Owner( ) Other: Address: Telephone: Fax: Email: Pleas check to specify who you wish correspondence to be mailed to,from the above names: (4AApplicant/Owner(s), ( )Authorized Representative, ( ) Other Name/Address below: N D TED FOR: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN and DENIED AN APPLICATION DATED S l5 2 uilding Permit ( ) Certificate of Occupancy ( )Pre-Certificate of Occupancy ( ) Change of Use ( )Permit for As-Built Construction ( ) Other: Provision of the Zoning Ordinance Appealed. (Indicate Article,Section,Subsection of Zoning Ordinance by numbers.Do not quote the code.) p Article: X y 11 1 Section: Subsection: Type of Appeal. An Appeal is made for: # 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, h"as not been made at an time with respect to this rq er , PP AiNLYear(s). UNDER A eal o s . (Please be sure to research before completing this question or call our office for assistance) Page 2, Area Variance Application Received Revised 6/2023 b�q,i JUL 14 2026 RASI`�l APPEALS (please be specific,additional sheets maybe used with preparer's signature notariz9ftning Board of Appeals 1. An undesirable change will not be produced in the CHARACTER of the neighbor or a detriment to nearby properties if granted, because: 1 7 TTiN GL F AGb V 15' � J pT►oa �FA�E 5 of I.arsn�-�IA�V�- 1 . ya►U. N o—T "-4 is/S l.e [ 7r-► STIR-�C� 1 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: ov= -%AG pO-erse-it s i7-r. 3. The amount of relief requested is not substantial because: opT SUww- 4. The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: -TY 5. Has the alleged difficulty been self created? { } Yes,or { No Why: 'tc .� Tom S•tau. • Are there any Covenants or Restrictions concerning this land? jr/(No { } Yes(please furnish a copy) • This is the MINIMUM that is necessary and adequate, and at the same time preserve and protect the character of the neighborhood and the health, safety and welfare of the community. By signing this document,the PROPERTY OWNER understands that pursuant to Chapter 280- 146(B)of the Code of the Town of Southold,any variance granted by the Board of Appeals shall become null and void where a Certificate of Occupancy has not been procured,and/or a subdivision map has not been filed with the Suffolk County Clerk,within three(3)years from the date such variance was granted. The Board may,upon written request prior to the date of expiration,grant an extension not to exceed three(3)consecutive one(1)year terms. IT IS THE PROPERTY OWNER'S RESPONSIBILITY TO ENSURE COII 'PLIANCE T'H THE CODE REQUIRED TIME FRAME DESCRIBED HEREIN. 3� Sign, ire of A icant or Authorized Agent (Age must submit written Authorization from Owner) rxar arari'this day Dawn Johnson %Notary Public,State of New York of a 20� ,�Qualified OIJ06149053 uall0ied in Suffolk County �^ "g wpe Commission Expires 10/11/J02r N � tt �ic' Zoning Board of Appeals APPLICANT'S PROJECT DESCRIPTION Received , APPLICANT: essU 3 � E 9-- SCTM No. 1. For Demolition of Existing Building Areas ,t.�orljng Board of Appeals Please describe areas being removed: O ES'C' S.L p':!5 6F II. New Construction Areas (New Dwelling or New Additions/Extensions): Dimensions of first floor extension: d Dimensions of new second floor: Dimensions of floor above second level: Height(from existing natural grade): '2 l Is basement or lowest floor area being constructed? If yes, please provide height(above ground) measured from natural existing grade to first floor: 0 III. Proposed Construction Description (Alterations or Structural Changes) (Attach extra sheet if necessary). Please describe building areas: a e V�a.wtt ls-t Pe U j Number of Floors and General Characteristics BEFORE Alterations: z fir" 00--Ir 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 property: Proposed increase of building coverage: Square footage of your lot. —� Percentage of coverage of your lot by building area(lot coverage) 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: 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 Received the subject remises currently listed on the real estate market for sale? A. Is Ott .� � JUL 14 2026 Yes No ,4 B. Are there any proposals to change or alter land contours? Zoning Board of Ppaai V/No Yes, please explain on separate sheet,. C. 1.) Are there areas that contain sand or wetland grasses?_ N' ) 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? - W A 4.) If your property contains wetlands or pond areas, have you contacted the Office of the BOARD OF TRUSTEES for its determination of jurisdiction? N PC Please confirm status of your inquiry or application with the Board of Trustees: If issued, please attach copies of your permit listing conditions of approval with a copy of the approved survey. D. Is there a depression or sloping elevation near the area of proposed construction at or below five feet above mean sea level? 1-30 E. Are there any patios, concrete barriers, bulkheads or fences that exist that are not shown on the survey that you are submitting? 140 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? Nb 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? a G 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 -f (examples:existing single family,proposed:same with garage,pool or other) Ahorize V' nature Dat ?41 I FORM NO. 4 Received oA l41 TOWN OF SOUTHOLD BUILDING DEPARTMENT JUL 14 2026 Office of the Building Inspector Town Hall Zoning Board Of Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29210 Date: 07/09/03 THIS CERTIFIES that the building ALTERATIONS' Location of Property: 660 KING ST ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No_ 473889 Section 26 Block 2 Lot 36 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEM'BER 21, 2001 pursuant to which Building Permit No. 27977-Z dated �DECEMBER 21- 2001 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is INTERIOR ALTERATIONS WITH NON-HABITABLE ATTIC TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to HOWARD SCHA,FFE& (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NfA ELECTRICAL CERTIFICATE NO. 1127014 06/12/03 PLUMBERS CERTIFICATION DATED N/A Authorized Signatu Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD Received BUILDING DEPARTMENT Office of the Building Inspector Town Hall JUL 14 2026 Southold, N.Y. 1-11 Zoning Board of Appeals PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 26339 Date: -03/19/99 THIS CERTIFIES that the building DWELLING fw ACCESSORIES Location of Property 66 KING ST ORIENT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 section 026 Block 0002 Lot 036 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DV%LLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 26339 dated MARCH 19, 1999 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING AND TWO ACCESSORY STORAGE SHEDS. .* The certificate is issued to MICHAEL BOGDEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. NIA PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT Building prctor Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD Received BUILDING DEPARTMENT office of the Building Inspector JUL 1 4' 2026 Town Hall Southold, N.Y. Zoning Board of APPaairl CERTIFICATE OF OCCUPANCY No: Z-26338 Date:'03/19/99 THIS CERTIFIES that the building ALTERATION Location of Property: 660 KING ST ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 26 Block 2 Lot 36 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 12, 1999 pursuant to which Building Permit No. 25618-Z dated MARCH 18, 1999 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ENCLOSE EXISTING GLASS AND SCREEN PORCH INTO LIVING SPACE "AS BUILT" FOR AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MICHAEL BOGDEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENS 03/03/99 PLUMBERS CERTIFICATION DATED N/A Build ng speota Rev. 1/81 FORM No.4 TOWN OF 50UTHQLD BUILDING DEPARTMENT Office of the Building Inspector Received Hall Southold, N.Y. JUL 14 2026 Certificate Of Occupancy Zoning Board of Appea16 No. . . . A 15248 . Date . . ,February �2. T1987 „ . THIS CERTIFIES that the building ,ADDITION TO ACCESSORY BUILDING .* . . . 600 King Street Orient , New York Location of Property . . . , . . . . . .. . . . . . . . . . . . . . . . House No. Str t �Marnlgt County Tax Map No. 1000 Section . . . 0 2 6 Block O . . . . . . . .Lot . . , ,0 3 6. . . . . . . Subdivision . . . . . . . „ . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . , .Lot No. . . . . . . . . . . . .. . conforms substantially to the Application for Building Permit heretofore filed in this office dated September 8 , .1.9.8.3 . pursuant to which Building Permit No. 12 6 1,2 Z . . . . . . . . . dated Se p t e mb e r 16 , 19 8 3 ,was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . . . ADDITION TO ACCESSORY BUILDING MICHAEL & CATHERINE BOGDEN The certificate is issued to , , , , (owner,'fiWWShW&ANff of the aforesaid building. Suffolk County Department of Health Approval . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . ., , . . . N . . . . . . . . , . .. .. . . . . . .. . .. .. N/A PLUMBERS CERTIFICATION DATED: . . . max- . . . . . . . . . . . . . . . . , Tiding Inspector Rev.1/87 i i TOWN OF SOUTHOLD BUILDING DEPARTMENT � TOWN CLERK'S OFFICE v c� � SOUTHOLD, NY gCgIVBC� BUILDING PERMIT SS..Y.FY JUL 14 2026 (THIS PERMIT MUST BE KEPT ON THE PREMISESNci3aara of'Appea� WITI I' ONE SET OF APPROVED PLANS AND SPE IFICA . UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date: 11/22/2019 Permit#: 44454 Permission is hereby granted to: Schaffer, Howard 49 Prince St New York, NY 10012 To: install an accessory generator as applied for. At premises located at: 660 King St., Orient SCTM # 473889 Sec/Block/Lot# 26. 2-36 Pursuant to application dated 11/18/2019 and approved by the Building Inspector. To expire on 5/23/2021. Fees: . . ........ ACCESSOR ��$100.00 -ACC $50.00 ELEC 1C $85.00 Total: $235.00� � Building Inspector TOWN OF SOUTHOLD, NEW YORK ACTION OF THE ZONING BOARD OF APPEALS DATE 1-7, 1964 Received Appeal No. 738 Dated November 16, 1964 tAl ACTION OF THE ZONING BOARD OF APPEALS OF THE 'IOW, OF SOUTHOLD JUL 14 202G Marjorie Douglass Appellant To King Street eats Orient, New York Zoning Board Of Appeals at a meiAivg of the Zoning Board of Appeals on Thursday, December 17, 1964the appeal was considered and the action indicated below was taken on your Request for variance due to lack of access to property ( ) Request for a special exception under the Zoning Ordinance (X) Request for a variance to the Zoning Ordinance 1. SPECIAI, EXCEPTION. By resolution of the Board it was determined that a special exception ( ) be granted ( ) be denied pursuant to Article............._.....Section Subsection paragraph ..........---.... of the Zoning Ordinance, and the decision of the Building Inspector { ) be reversed ( ) be confirmed because 8:15 P.M. (E.S.T,) , Upon application of Marjorie Douglass, King Street, Orient, New York, for a variance in accordance withthe Zoning Ordinance, Article III, Section 303, 304, 307, and Article X, Section 1000A, for permission to divide and sell property with insufficient frontage. Location of property: south side King Street, Orient, New York, bounded north by King Street, east by other land of Marjorie Doughlass, south by Robert Douglass, west by Nelson Douglass Estate. 2. VARIANCE.By resolution of the Board it was determined that (a) Strict appliaatLon of the Ordinance (would)(would not) produce practical difficulties or unnec- essary hardship because SEE REVERSE (b) The bardarip created (is) (is not) unique and (would) (would not) be shared by all propertles alike in the lmmedlate vicinity of this property and in the same use district because SEE REVERSE (c) The variance (does) (does not) observe the spirit of the Ordinance and (would) (would not) change the character of the district because SEE REVERSE and therefore, it was further determined that the requested variance ( ) be granted ( ) be denied and that the previous decisions of the Building Inspector ( ) be confirmed ( ) be reversed. INO BOARD OF APPEAIS FORM ZB4 Barbara L.Carroza, Secretary Received ' fn. After investigation and inspection the Board finds that JUL 14 2026 the applicant wishes to divide and sell property with insufficient frontage and area. The Board finds that the property in question is 59.69 feet in the front, 58 feet in the rear, and 155 feet Zoning Board of Appeals deep. The Board is in complete agreement with the reasoning of the applicant as stated in the written application to this Board. Specifically, there will be no change in the character of the neighborhood. There is no way to enlarge this lot. The Board finds that strict application of the Ordinance will produce practical difficulties or unnecessary hardship; the hardship created is unique and would not be shared by all properties alike in the immediate vicinity of this property and in the same use district; and the variance does observe the spirit of the Ordinance and will not change the character of the district. Therefore, it was RESOLVED that Marjorie Douglass, King Street, Orient, New York, be ranted permission to*div&de and sell property with insufficient frontage on property located south side King Street, Orient, New York. * * x Received AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS JUL 1 2026 190 TOWN OF SOUTHOLD WHEN TO USE THIS FORM: This farm must be completed by the qpplicaatj&�flq30PP[ht RjeApp8815 permit,site plait approval, use variance, area variance or subdivision approval on property within an agricultural district OR within 500feet of afarm operation located in an agricultural district. All applications requiring an agricultural data statement must be referred to the Suffolk County Department of Planning in accordance with Section 2391n and 239n of the General Municipal Law. 1. Name of Applicant: ........... X. 1195 2. Address of Applicant: 4160 r---1"Ji STOZ45,7 or—to.,-6--M .......... *3 3. Name of Land Owner(if other than Applicant): 4. Address of Land Owner: ................... 5. Description of Proposed Project:. v ............. A. 6. Location of Property: (Road and Tax map Number)—y . ......... —"—------..... .................7. �s the parcel within 500 feet of a farm operation? {V,�Ves f I No 8. Is this parcel actively farmed? f I Yes {vJ 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. NIAM.[-: ndADDRJES—S ,0%0y.13 d 490 0?<*iAVIO $rr, LL-C- r ............ —------- opoit� -J 2. ............. ........ 5. 6. ........ (Pleas use the bac of this page if there are additional property owners) —---—-------- �j�n� e of pp ihA cant Dat Note: 1. The local Board will solicit comments from the owners of land identified above in order to consider the effect of the proposed action on their farm operation. Solicitations will be made by supplying a copy of this statement. 2. Comments returned to the local Board will be taken into consideration as part as the overall review of this application. 3. Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above. The cost for mailing shall be paid by the Applicant at the time the application is submitted for review. 617.20 Received Appendix B JUL 14 826 Short Environmental Assessment Form Instructions for Completin Zoning Board of Appeals 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 1 based on information currently available. I'fadditional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1 -Project and Sponsor Information Name of Action or Project: V.�r rk j ADQ cri w- Project Location(describe,and attach a location map): lo& o V, 1 tJC' 5T. orz-1 ��- N • I I.� 5 Brief Description of Proposed Action: Name of Applicant or Sponsor: Telephone: q 17 6 g 6 —53 7 6 ovJb`1Z� �yG d Fr �� E-Mail: NO WSG44A PF «+ ,�lW�_T 1 lr.coy Address: 66 a ILA a s-r P- 1 i C1 s77_ City/PO: State: JZ�e: o rz l tj u� 'f, S 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: / 3.a.Total acreage of the site of the proposed action? ZOO 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? O acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial WResidential(suburban) ❑ Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 8�0 5. Is the proposed action, MUdivieu NO YES NIA a.A permitted use under the zoning regulations? V JUL 14 b.Consistent with the adopted comprehensive plan? � 6. Is the proposed action consistent with the predominant character of the existi built or at NO YES P P oning &grrg of Appeal landscape? V i 7. Is the site of the proposed action located in,or does it adjoin,a state lusted Critical Environmental Area? NO YES If Yes,identify: 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies:. 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: Y 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? b.Is the proposed action located in an archeological sensitive area? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? f If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: n Qr r n o c 1 r ri p° 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 plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO❑YES Page 2 of 4 r N 18.Does the proposed action include construction or other activities that result in t i NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: / 19.Has the site of the proposed action or an adjoining property been the locatioW&MW 1 e NO YES solid waste management facility? If Yes,describe: - / 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: V I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE O THE BEST OF MY KNOWLEDGE S�� Dater Applicant/sponsor name: � Signa Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur I„ Will the proposed action create a material conflict with an adopted land use plan or zoning V 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)? v 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available enM conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, / waterbodies,groundwater,air quality,flora and fauna)? I/ Page 3 of 4 eve No,or Moderate Pi small to large ,uL 2026 impact impact 4 may may 1 occur occur 10. Will the proposed action result in an increase in the potential foie , �rain�age f problems? It. 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, .. 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 prgject 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 APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORMI The Town ofSouthold"s Code of Ethics ptoghlbits'conflicits of interest on the part of town officers and eem In ee ,.1 this form is.to r vid nform i hie n the tow f Possible conflicts f ate t_and all w it to take l,l necessary to avoid same. 1 YOUR NAME: 14b -� � —�C12— JUL 14 2026 (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) Zoning Board of AppealS TYPE OF APPLICATION:(Check all that apply) Tax grievance Building Permit Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest"means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee. Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) Q an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this da f ba .20 N Signature Print Name G Received Town of Southold L, CONSISTENCY ASSESSMENT FORM JUL 14 2026 Zoning Board of Appeals A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. if an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. ,B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# The Application has been submitted to (check appropriate response): Town Board Planning Dept. D Building Dept. [X 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: Location of action: 10(ao Received Site acreage: . v�O -JUL 14 2026 Present land use:. L WA r-+,L-4 04FL-�►f4 t2-es►�r>k 3t7 a.l. Zoning Board of Appeals Present zoning classification: r'-Z 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: b Mailin g address:, (c) Telephone number: Area Code( ) -1 (d) Application number, if any: Will the action be directly undertaken, require funding,or approval by a state or federal agency? IYes 10 No E?"" If yes, which state or federal agency? EVELOPEDCOAST 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, males beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III_..Policies; Page 2 for evaluation criteria. Yes No ❑ (Not Applicable- 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 EH No ❑ (Not Applicable—please explain) Received 660 KING ST. EXTERIOR PHOTOS : 5/26/2026 JUL 14 2026 NORTH WEST VIEW NORTH VIEW Zoning Board °a Ap.peMt- n s r rr y NORTH WEST VIEW NORTH WEST VIEW GS D E S I G N 'h Received 660 KING ST. EXTERIOR PHOTOS : 5/26/2026 EAST VIEW EAST VIEW Zoning Board of Appeal IF SOUTH EAST VIEW NORTH EAST VIEW GS r. � F DESIGN Received JUL 14`.2026 660 KING ST. EXTERIOR PHOTOS : 5/26/2026 Zoning Board of Appeals SOUTH VIEW SOUTH VIEWs"� f I I r' ,e i /,�16(�1r�ii�R�6llrrre�,o a a'" " r SOUTH EAST VIEW SOUTH SHED GS DESIGN rx TOWN OF SOUTHOLD PROPERTY RECORI Iac) 17 OWNER STREET VILLAGE DIST SUB. LOT FORMER OWNER 1f, N E .,,. ACR. J S W v TYPE OF BUILDING v Ro RES.:) SEAS. \1L FARM V COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS y/ t,E -7 zr 6� v BUILDING CONDITI?N- -4- - 7 J U N EW -2 FARM Acre Value Per value Acre Tillable I Tillable 2 N Tillable 3 CD Woodland 0 C= SwamplandT— FRONTAGE ON WATER < Brushland FRONTAGE ON ROAD House Plot DEPTH !BULKHEAD Total IDOCK g ` f;✓ I - - _ o i LOR I -M _emu t - .- i I-41 l i r - 01 26-2-36 02/02 4 i l 4 M. Bldg. - Foundation Bath i Dinette Floors Kasemen!Bt j Fl -- Extension i Extension i — ( '�, mw"; °� i n ;.Ext. Walls ' �'� Interior Finish LR. J In ef)� j Extension /Fire Place Heat I I DR. { a0(D :Type Roof _ j Rooms lst Floor- BR. Porch ) �� _ W> � , = f °a_' 32 a 'Recreation Room ? Rooms 2nd Floor FIN B ;_ �. ® - Porch �; +� _ f: r 5 o Dormer ; Breezeway ' ' Driveway Y Garage �c) Patio _ / r3 , � v'•a � �i (D t O. B, 27 .n� 1 CD Total - -r _�_ 101 CD �.. , CMI _