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HomeMy WebLinkAbout8163 Received FORM NO. 3 OCT 2 Z026 TOWN OF SOUTHOLD Zoning Board of Appeals BUILDING DEPARTMENT SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL DATE: June 10, 2026 REVISED: July 28, 2026 REVISED: September 14, 2026 REVISED: October 2, 2026 TO: Kenneth J Alessi 175 Inlet Dr Mattituck, NY, 11952 Please take notice that your application dated May 13, 2026: For permit to: construct an inground swimming pool accessory to an existingsingle- family ng1e- family dwelling and to relocate two sheds to meet the required accessory setbacks at: Location of property: 175 Inlet Drive, Mattituck, NY County Tax Map No. 1000—Section 106 Block 2 Lot 23 Is returned herewith and disapproved on the following grounds: The proposed construction on this non-conforming 12,196.8 sq.ft. parcel in the R-40 residential district based on the Alphonse Pesce Jr survey dated June 27, 2026, is not permitted pursuant to Article XXIII Section 280-124, which states lots measuring less than 20,000 square feet in total size require a maximum lot coverage of 20%. The survey shows a calculated lot coverage of 28.7%. 41)17LO-i I 'y 2yunu horized Signa 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 i �� FORM NO. 3 8`� TOWN OF SOUTHOLD Received ' BUILDING DEPARTMENT SOUTHOLD,N.Y. OCT 1 2'026 it y NOTICE OF DISAPPROVAL Zoning'Board of Appeals DATE: June 10, 2026 REVISED: July 28,2026 REVISED: September 14,2026 TO: Kenneth J Alessi 175 Inlet Dr Mattituck,NY, 11952 Please take notice that your application dated May 13, 2026: For permit to: construct an inground swimming pool accessory to an existing single- family dwelling and legalize two existing sheds at: Location of property: 175 Inlet Drive, Mattituck,NY County Tax Map No. 1000—Section 106 Block 2 Lot 23 Is returned herewith and disapproved on the following grounds: The proposed construction on this non-conforming 12,196.8 sq.ft. parcel in the R-40 residential district, based on the Alphonse Pesce Jr survey dated June 27, 2026, is not permitted pursuant to Article XXIII Section 280-124, which states lots measuring less than 20,000 square feet in total size require a maximum lot coverage of 20%. The survey shows a calculated lot coverage of 28.7%. Additionally,legalizing the sheds is not permitted pursuant to Article III, Section 280-15, which states accessory buildings and structures shall be located in the required rear yard. The survey shows both sheds to be located in other than the rear yard. jW �FUJU_P_A M4_4� .9 Aulyrized Signat e 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 P' FORM NO. 3 Received TOWN OF SOUTHOLD OCT 2. 2026 BUILDING DEPARTMENT Zoning Board of A SOUTHOLD,N.Y. Appeals NOTICE OF DISAPPROVAL DATE: June 10, 2026 REVISED: July 28,2026 TO: Kenneth J Alessi 175 Inlet Dr Mattituck,NY, 11952 Please take notice that your application dated May 13,2026: For permit to: construct an inground swimming pool accessory to an.existing s nrle- family dwellina.at: Location of properly: 175 Inlet.Drive, Mattituck.NY County Tax Map No. 1000—Section 106 Block 2 Lot 23 Is returned herewith and disapproved on the following grounds: The proposed construction on this non-coriforming.12.1.96.8_sg.ft. parcel in the R4.0 residential district is not permitted pursuant to Article XXIII Section 280-124.,vvhich states lots measuring less than 20,000 square feet in total size require a.maximum lot coverage of 20%. The survey shows a calculated lot coverage of 28.7%. Aut1rized 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 r Received APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS OCT 2: 1D26 AREA VARIANCE Zonin Boar House No. 1-76 Street ,,--Pi'"�` br Hamlet Ci d Of Appea s SCTM 1000 Section: Block:_CZLot(s)-Lot Size: o J Zone I(WE) +AL THE,WRITTEN DETERMINATION OF THE BUILDI +CTOR DATE . BASED ON SURVEY/SITE PLAN DATE Owner(s)• ffiAk�I& Ty. maih-h-LL g Mailin Address: - c, Telephoti�:•�� Email: NOTE:In addition to the above,please complete below if application is signed by applicant's attorney,agent, architect,builder,contract vend etc.and name of pers n who eg epresents: Name of Representative: Owner( ) Other: Address: 1 l �! VT Telephon103 �(4-'a-3-3-6�'7 Emai : AizS w 0 (� Please check to specify who yo i correspondence to be mailed to,from the above names: ( )Applicant/Owner(s), Authorized Representative, ( )Other Name/Address below: WHEREB .'THE BU�H,I?ING INSPECTOR REVIEWED SURVEY/S PAN DATE V and DENIED AN APPLICATION DATEJ� FOR: uilding Permit ( ) Certificate of Occupancy ( ) Pre-Certificate of Occupancy O Change of Use ( )Permit for As-Built Construction r ( )Other: Provision of the Zoning Ordinance Appealed. (Indicate Article,Section,Subsection of Zoning Ordinance by numbers.Do nolsawte the code.) n Article: Section: aq y_k�? 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, has 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 Received Revised 6/2023 OCT 2. 2o26 REASONS FOR APPEAL Zoning Board of Appeals (Please be specific,additional sheets may be used with preparer's signature notarized): 1.An undesirable change will not be produced in the CHARACTER of the neighbor or a detriment to nearby properties if granted,be iause: , —M' j t_- 0jrMtn _#)ersW)m '114 aR,�� Kq� & p(bpq+q GA. -IfLe-, 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: pn-p" p� r0l J pafr d . 3.The amount of relief requested is not substantial because: 4. The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: 5. Has the alleged difficulty been self created? {�} Yes,or No Why: . • Are there any Covenants or Restrictions conceining this land? o { }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`;RotIttlien ped three(3)consecutive one(1)year terms. IT IS THE PROPERTY OWNER`, S ,ITY TO ENSURE COMPLIANCE WITH THE CODE REQUIRED TIMIE HEREIN. N0.01MI623165i% r QUALIFIED N SUFFOLK CO Ty COMM., P. se 11-Ue`\r ;o�� ture of Applicant or Authorized Agent OF N i\"-l\`\�� (Agent mu ubmit written Authorization from Owner) Sworn to before me this 0 day of , 0 AVO Notary PuBlic Received Zoning Board of Appeals OCT 2 2026 APPLICANT'S PROJECT DESCRIPTION Zoning Board of Appeals APPLICANT: vVX�C HS IBC/ SCTM No. Lbl)o 1.For Demolition of Existing Building Areas Please describe areas being removed: II.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: Number of Floors and Changes WITH Alterations: IV. Calculations of building areas and lot coverage,s;Kkv plane ffrom Surveyor,Design Professional): Existing square footage of buildings on yourproperty: " Proposed increase of building c era e: ,�a /Q Square footage of your lot: , ' Percentage of coverage of your to 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.P r ose of 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 i 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. Received R vised 6/2023 QUESTIONNAIRE ��r 2, Z026 FOR FILING WITH YOUR ZBA APPLICATION Zoning Board of Appeals A. Is the subject p ises currently listed on the real estate market for sale? Yes No B. a there any proposals to change or alter land contours? No Yes,please explain on separate sheet. �j'� C. 1.)Are there areas that contain sand or wetland grasses? �v 2.)Are those areas shown on the survey submitted with this application? 3.)Is the r p y bulk headed between the wetlands area and the upland building area? 4.)If you property contains wetlands or pond areas,have you contacted the Office of the BOARD OF TRUSTEES for its determination of jurisdiction? Please lirnmn status of your inquiry or application with the Board of Trustees: If issuAd,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 nea Xtie rea of proposed construction at or below five feet above mean sea level? E. Are there any patios,concrete barriers,bul ds or fences that exist that are not shown on the survey that you are submitting? If any of the aforementioned items exist o our property,please show them on a site plan. F. Are there any construction projects currently in process on your property? Q 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? If yes,please label the proximity of your lands on your survey and identify the Su ff k County Tax Map No. I. Please 1 t Ares t use or perations conducted at your prop , and/or the proposed use J. (exa 1 s:exis ng single fami y, oposed:same with garage,pool oJ other) Authorized signatu Date FURM NU. 4 *8t� Received TOWN OF SOUTHOLD OCT BUILDING DEPARTMENT ZOZ6 Office of the Building Inspector Zoning Town Hall Board Of AAPeals Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30789 Date: 03/08 05 THIS CERTIFIES that the building NEW DWELLING Location of Property: 175 INLET DR MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 106 Block 2 Lot 23 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 27, 2003 pursuant to which Building Permit No. 2 94 6 6-Z dated JUNE 6, 2003 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is SINGLE FAMILY DWELLING WITH ATTACHED TWO CAR GARAGE, COVERED FRONT PORCH AND A NON-HABITABLE 2ND STORY AS APPLIED FOR. The certificate is issued to KENNETH J ALESSI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-02-0073 10 18 04 ELECTRICAL CERTIFICATE NO. 84085H 08 31 04 PLUMBERS CERTIFICATION DATED 08 25/04 L&J PLUMBING & HEATING Authorized Signature Rev. 1/81 �o��pF80(/Tyo`o Town of Southold Received * P.O. Bog 1179 �0 53095 Main Rd CnuxTr. Southold, New York 11971 CT 2026 Zoning Board of Appeeis CERTIFICATE OF OCCUPANCY No: 46995 Date: 04/23/2026 THI5 CERTIFIES that the building SOLAR PANEL Location of Property: 175 Inlet Dr Mattituck, NY 11952 Sec/Block/Lot: 106.-2-23 Conforms substantially to the Application for Building Permit heretofore,filed in this office dated: 06/12/2025 Pursuant to which Building Permit No. 52075 and dated: 07/09/2025 Was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: Roof-mounted solar panels to existing single-family dwelling as applied for. The certificate is issued to: Kenneth Alessi Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 113154 9/25/2025 PLUMBERS CERTIFICATION: Au horize ignature Received AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS OCT 2 2026 TOWN OF SOUTHOLD Zoning Board of Appeals WHEN TO USE THIS FORM: This form must be completed by the applicant for any special use permit, site plan approval, use variance, area variance or subdivision approval on property within an agricultural district OR within 500 feet of a farm 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 239m and 239n of the General Municipal Law. 1. Name of Applicant:( Y 2. Address of Applicant: T 7 3. Name of Land Owner(if other thV14 ican): 4. Address of Land Owner:f ) 5. nption of Pr posed Project: M6. Location of Property: oad and�7-m�y ber) if U/,l Ltl- L Y J 00-- 166 T- 7. Is the parcel within 500 feet of a farm operation? { } Yes o 8. Is this parcel actively farmed? { } YesX,No 9. Name and addresses of any owner(s) os nd 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) 'y , �o , A S' ature 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. -�17_ e�\G-'3 eceived 617.20 Appendix B OCT 2. 2026 Short Environmental Assessment Form Zoning • Board of Appeals Instructions for Completing Part 1-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. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency; attach additional pages as necessary to supplement any item. Part 1 -Project and Sponsor Information Name of Action or Project: Project Location des]be,and attach a location m p) Brief Description of Proposed Action: Nameicant or S onsor: Telephone: S,;f E-Mail- S CO AdV: j(�" 1 I � City/PO: /)� State:� N�/ I Zjp C�d�� 1.Does the proposed actionVation? my involve the legislative adoption of a plan,local law,ordinan e, `c NO YES administrative rule,or re 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? s acres b.Total acreage to be physically disturbed? 6+0 c s—fL�J 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 ❑ Commercial esidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑ Other(speci ❑Parkland Page 1 of 4 75 Received 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? OCT 2. 2026 b. Consistent with the adopted comprehensive plan? Zoning Beard ef 6. Is the proposed action consistent with the predominant character of the existing built or ri"MraeP8 NO YES landscape? 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: K 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: .X 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: X 12. a. Does the site contain a structure that is listed on either the State or National Register of Historic NOO YES Places? b.Is the proposed action located in an archeological sensitive area? X_ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑ Shoreline ❑ Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban Xuburban 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? O YES If Yes, a.Will storm water discharges flow to adjacent properties? )40 ❑YES b.Will storm water discharges be directed to established conveyance systems-runff o and storm drains)? If Yes,briefly describe: NO ❑YES Page 2 of 4 vl�- EkG� Received 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)? OCT 2 Z026 If Yes,explain purpose and size: Zollilly Board o ppe I 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? 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: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor n e: Date: ehln 12,e- Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 Received No,or Moderate small to large OCT 2 Z026 impact impact may may Zoning Board oi Appeals occur occur 10. Will the proposed action result in an increase in the potential for erosion, flooding or drainage 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 environme tal impa S. *ZA AJ I YO b M 0J �Nam of Le g ncy ate � � 0A'A==f=, Print o Type ame pf 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 i Board of Zoning Appeals Application Received OCT 2. z026 OWNER'S AUTHORIZATION Zoning Board of Appeals (Where the Applicant is not the Owner) Y-75-7 LUt f /� ��,'�residing at �` ! � � l��f I�i ���'�� Print property own Ws name) (Mailing Address) do hereby aLthorize -_ ,6 (Agent) to apply for variance(s) on my behalf from the Southold Zoning Board of Appeals. By signing this document,the Property Owner understands that pursuant to Chapter 280- 146(B)of the Code of the Town of Southold any variance granted by the Board of Appeals shall become null and void where a Certificate of Occupancy has not been procured, and/or a subdivision map has not been filed with the Suffolk County Clerk,within three(3)years from the date such variance was granted. The Board of Appeals may, upon written request prior to the date of expiration,grant an extension not to exceed three(3)consecutive one (1)year terms. IT IS THE PROPERTY OWNER'S RESPONSIBILITY TO ENSURE COMPLIANCE WITH THE CODE REQUIRED TIME FRAME DESCRIBED HEREIN. a �-- (Owner's Signature) (Pri t Owner's Name) ReCe1Ved APPL . ANT/ WNER OCT 2, TRANSACTIONAL DISCL FORM ,7 n� 2�Z6 The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and®rtSXv"3 a rpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatev ea1S action is necessary to avoid same. YOUR NAME : (Las name,first name,middle initial,/unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning Do you personally(or,through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest"means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balm ce of this form a d late and sign where indicated. Name of person employed by the Town of Southold —7 A-///74— 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 o 4 Signature Print Name Ak- t� Received OCT 2. 2026 GENT/REP ENTATIVE TRAN TIONAL D SCLOSURE FORM °Wing Board of aPPeafs 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 sam ]n Q YOUR NAME (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Perini Variance Trustee Per Change of Zone Coastal Erosion Approval of Plat A Mooring Other(activity) PZ1 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 b nce of this form and dateand 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 ko Submitted this day of / ,ua�� Signature Print Name GAS IX� E�1�3 Town of Southold Received LWRP CONSISTENCY ASSESSMENT FORM OCT 2 2026 A. INSTRUCTIONS Zoning $oard of Appeals 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. DE SCRIPTION OF SITE AND PROPOSED ACTION SCTM# `- 01/ �° J The Application has been submitted to (check appropriate response): �� /� ,0�Jr] Town Board D Planning Dept. © Building Dept. 0 Board of Trustees 0 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital construction,planning activity, agency regulation, land transaction) 0 (b) Financial assistance(e.g. grant,loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: flrwa _-ej rt��-a- MARece�Ve� Location of action: - /C Site acreage: o �Q � T 2 2026 � 1 �vl . Present land use: �S ) �� ��is Present zoning classification: 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: to4 (b) Mailing address: P4— (c) Telephone number: Area Code (d) Application number, if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No If yes,which state or federal agency? DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ❑Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No ❑ Not Applicable - z i• { , JAh _ T moll _ III— ON*!,� !flF 1 �may: _... .. ..,.,....•r _ �� _ .� sa^^ 'yvJ. � �` t`�� ,�., •4fR` • ,a .� �_•=.! t: :^4,.,tE�t,,,tws'y �i \�• �1 j�* +r71�►•✓ -�, k}. • /• ! .+�, ' .S .,"-_�e. .! a �'I � ••�. 'a �� s Lf" t�ei'�j a .� r -Y_. •sk- .• # i`d S�r�. •..,� f 3•,�rS ' -� ��lr y• ,1-''" •, f^ ;., _ - a .' 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'�y�U "3" t }H. y1 M tni S '�'r� "� $I �ltd�f' � : Yt► - �r� �� \�y t f "�I�,rY �'�►� ��� Rj ��^qr��� .4„� , .N Vt�'�iA�� }'+ ' 1: � a fi• :� � ft;� .� !ims (� '_`- °a 4 �✓ }; ,/ "�' e .r �.. 1�."� i:,.'c"T� M7�,!x' "' u• ,- t 'j i' .';�' } :i ,i �r. ice'',, •�, .a +d � '����. ,t�,.. �,�. � •�i AT.. ^� c ��„ .�4 i�+,tf�,i_4 � y��.��yr'.'�1�`r�l r1'1`-1 `p'�. �}�y Ml��;°''� :1•;i°�7°'7c !! s 'A+'t 1... 9 �_ reY.�C'.;.,.a:.Q 'd►.aLirs:.`R�aa ,�.! '.' ;°R':` ..,4_ r el":rt''�s.s_....�..k,,�.�.-; .�tiYCl.. t �e` .�+i�'u�•iAe ' ' Y,.. ]! MN rr TOWN OF SOUTHOLD PROPERTY RECORD CARD k ' STRIET VfLLAGE DISTRICT t Rl SUB, �. k ve, " a rM, lN " ! eta i - S, w TYPE OF BUILDING ICES EAS. VL `? FARM COMM � IND. � C8 MISC, Est, Mkt, Value LANES IMP TOTAL GATE REMARKS 1 y _� ""w� '"'✓ ^s �f „a<I'� .- p.. 1 !. _.. - Ir r�.. T ;_. '' Iea` .__-..�.@- of f k a+i AGE BUILE Ih:CCGNDlTtflN —1 r7. 4 5 NEW NORMAL BEE,O'wie° } ABOVE. I FPONTAGE ON WATER Form ! Arrc Value Per e'cre Value FRONTAGE ON ROAD TMable 1 946Y� ;;,ckale 2 _ X}CK ' i : ._ ' i9saiti � - ro Tillable 3 a Cr `= _.- c1li slvt> tIIC1r7c rY ' cc�t Q ' U .. Brush lond � U c� m s tt ot Total ...,...._�..�.._ ._._...� _ems. _ _...__.._..._._,..._......._,,._., ._.,,__._ i l f Jono l oL, 1 r i ) v i 5 j " 106.-2-23 3/05 L _ Pout M. Bldg Foundation Bath f -.-. -- - --- --- -' -r--_ - ----- --- -- Extension ' Basement * Floors I Extension i �� k " `-� 0 Fxt. Walls v« t.e Interior Finish Extension Fire Place Heat Porch a Roof Type -7K Is50 i ( 2 3 Porch Rooms 1 st Floor i $ - ' 2c Patio �► ao 2nd Floor Garage iL ? ?2 - ! �� i Driveway N NDorn—Der " - - ----------- - ---- - —— --- r a. r ta, k4(r 0 NOTES ` eceived 1. NO SOIL SURCHARGE PERMITTED WITHIN 4FEETOF EXCAVATION ATTHE SHALLOW END.OR6FEET'OF EXCAVATION AT THE PEEP END. v v 2. THIS POOL MEETS THE REQvIREMENTS OFAN51/APSP/ICC-5 AMERICAN NATTONALSTANDARD FOR RESIDENTIAL INGROUND SWIMMING N 10• 40, 10' POOLS"AND 1996 BOCA CODE-SECTION 421.DIVING EQUIPMENT IS NOTALLOWED. O OCT 2.. 2026 5. SWIMMING POOL SHALL BE COMPLETELY AND CONTINUOUSLY SURROUNDED NTH A BARRIER CONSTRUCTED LAW REQVIREMENTSOF SECTION R328.4.2.1 THROVGH R3264-9 OF THE NEW YORK STATE RESIDENTIAL CODE(2025)AND IN CONFORMITY WITH ALL SECTIONS d OFTHE SOUTHOLD TOWN CODE.DWELLING WALL(5)MAY SERVE AS PARTOF THE POOL BARRIERAS PER SECTION R528.4?8 AND Zon g Board of Appeals CONDITION(1)ARE MET.OPERABLE WINDOWS IN THE WALLS)USEDASA BARRIER SHALL HAVEA SELF LATCHING DEVICE.ACCE55 GATES C2f SHALL COMPLY WITH SECTION R3 8.4.7 OF THE NYS RESIDENTIAL CODE(2025)AND BE SELF CLOSING,SELF LATCHING AND BE SECURELY t�//'� Er A LOCKED WHEN POOL IS NOT IN USE OR SUPERVISED.ALL GATES ARE TO OPEN AWAY FROM THE POOL AREA. J Fn 6 A 4. DURING CONSTRUCTION THE CONTRACT'ORSHALL ERECTA TEMPORARY BARRIER AROUND THE EXCAVATION LAWTHECODEOFTHE O tom\ Hm H2O TOWN OFSOUTHOLD. O Q 5. POOL MUST BE EQUIPPED WITH AN APPROVED POOL ALARM CAPABLE OF DETECTING ENTRY INTO THE WATER AND SOUNDING AN } AUDIBLE ALARM UPON DETECTION THAT 15 AUDIBLE AT POOLS)DE AND INSIDE THEDWELLING.THE ALARM MU5TBEINSTALLED, V v MAINTAINED AND USED IN ACCORDANCE WITH THE MANUFACTURERS INSTRUCTIONS.THE AL.ARMMVSTMEETASTMF7?OS z QZ 'STANDARD SPECIFICATION FOP,POOLALARMS.THE DEVICE MUSTOPERATEINDEPENDENT(NOTATTACHEDTOOPDEPENDENTON)OF ][ ryw' o PERSONS. w 3 PLAN 6. POOLSUCTIONFITTINGS(E(CEPTFORSURFACESKIMMERS)MUSTBEPROVIDEDWITHACOVERTHATCONFORMSTOANSI/APSPACC16OR A A MINIMVM 18"x 23"DRAIN GRATE ORA CHANNEL DRAIN SYSTEM. POOL CIRCULATION SYSTEM MUST BE EQUIPPED WITH ATMOSPHERIC e-u B VACUUM RELIEF IN THE EVENTTHE GRATE COVERS LOCATED WITHIN THE POOL BECOME MISSING OR BROKEN.SUCH VACUUM RELIEF N �d N.TS. SYSTEMS SHALL CONFORM WITH ASMEA112.19.17 OR BEA GRAVITY SYSTEM APPROVED BY THE TOWN OFSOVTHOLD. POOLSHALLBE PROVI DIED WITH A MINIMUM OF2 SUCTION FITTINGS OF THE ABOVE MENTIONED TYPE.THE SUCTION FITTINGS SHALL BE SEPARATED BYA MINIMUM OF3'AND MUST BE PIPED SUCH THAT WATER IS DRAWN THROUGH THEM SIMULTANEOUSLY THROUGH A VACUUM RELIEF-PROTECTED LINE TO THE PUMP(OR PUMPS) VACUUM/PRESSURE CLEANING FITTINGS SHALL BE IN AN ACCE551BLE POSITION, 16'VINYL COVERED STEPS MINIMUM OF 6'AND NO GREATER THAN 12'BELOW TH E MINIM VM OPERATIONAL WATER LEVEL OR BE AN ATTACHMENT TO THE SKIMMER/SKIMMERS.A REQUIRED POOL ATMOSPH ERIC VACUUM RELIEF SYSTEM SHALL BE INSTALLED AS PER NY5 RESIDENTIAL CODE R328 SVNDECK (2025)AND IN ACCORDANCE WITH TOWN CODE 7. ALL ELECTRICAL WORK SHALL COMPLY WITH THE REQUIREMENTS OF NFPA 70(NEC)PRINCIPALLY ARTICLE 680 AND THE NYS ° m REE51PEN71AL CODE SECTIONS 4201 THROUGH 4209.ALL ELECTRICAL DEVICES MUST BEAPPROVED BY UNDERWRITERS LABORATORIES AND ? BE PROTECTED BY A GROUND FAULTCURRENT INTERRUPTER(GFC0 CURRENT CARRYING ELECTRICAL CONDUCTORS EXCEPT FOR THOSE PROVIDING POWER TO POOL LIGHTING AND POOL EQUIPMENTSHALL MEET THE SEPARATION REQUIREMENTS OF E4203.ALL METAL Lir ro 4 SAND BOTTOM ENCLOSURES,FENCES OR RAILINGS NEAR OR ADJACENT TO THE SWIMMING POOL THAT MAY BECOME ELECTRICALLY CHARGED DVE TO Li CONTACT WITH AN ELECTRICAL CIRCUIT SHALL BE EFFECTIVELY GROUNDED. QJ "CT S. WATER SOURCE FILLING THE POOL SHALL BE EQUIPPED WITH A BACKFLOW PROTECTION DEVICE LAW NYS PLUMBING CODE 608. cn 14 V In SECTION A 9. ALL PIPING 15 DIAGRAMMATIC UNLESS OTHERWISE STATED. `O N.T.S. 10. WALKS IF PROVIDED SHALL BE NONSLIP AND SLOPE AWAY FROM POOL EDGE 0 In ? Z WATER LINE TOP OF WALL 11. A MEANS OF EGRESS FOR DEEP AND SHALLOW ENDS MUST BE PROVIDED IAW ANSI/APSP/ICC-5 SECTION 6. - Q - 3 N 4, g, 4' 12 CONTRACTOR TO PLACE THE POOL LAW TOWN OF SOUTHOLD CODE SETBACKS. O 0 tri 13. ALL DRAINAGE FROM THE POOL SHALL BE MAINTAINED ON THE SUBJECT PROPERTY. C 0. ~ `- m;4 NI 15. THE DESIGN 15 BASED ON A DRAINAGE SOIL WITH<10%SILT.GROUND WATER SHALL NOT EXIST WITHIN THE EXCAVATION. IFGROUND WATER EXISTS WITHIN 6'-0'FROM GRADE,DEWATERING FACILITIES WILL BE REQUIRED. �o 16. ALL GASAND OIL HEATERS(IF INSTALLED)FOP THE INGROVND SWIMMING POOL SHALL BE NAT 0NALAPPLIANCE ENERGY SECTION B CONSERVATION ACT(NAECA)COMPLIANT. POOL HEATERS SHALL BE TESTED IAW AN51 Z221.56 AND SHALL BE INSTALLED IAW MANUFACTURERS SPECIFICATIONS. OIL FIRED POOL HEATERS SHALL BE TESTED LAW UL726. POOL HEATERS SHALL BE LOCATED OR N.T.S. GUARDED TO PROTECT AGMNSTACCI DENTAL CONTACTOF HOTSURFACES BY PERSONS. POOL HEATERS SHALL BE PROVIDED WITH TEMPERATURE AND PRESSURE-RELIEF VALVES. FOR HEATERS NOT PROVIDED WITH AN INTEGRAL BYPA55 SYSTEM.A BYPA55 LINE SHALL BE INSTALLED FROM INLET TO OVTLETTO ADJUST WATER FLOW THROUGH THE HEATER. POOL HEATERS SHALL BE PROVIDED NTH THE FOLLOWING ENERGY CONSERVATION MEASURES: An 2'-2' a CHECK VALVE - 10. 16.1 AT LEAST ONE THERMOSTAT SHALL BE PROVIDED FOR EACH HEATINGSYSTEM. 00 c CODING AND WALKWAY (BYOTHEPm , 16.2 ALL POOL HEATERS SHALL BE EQUIPPED WITH AN ON-OFF SWITCH MOUNTED FOR EASY ACCESS TO ALLOW SHUTTING OFF THE PVMP FROM WMMER GRADE OPERATION OF THE HEATER WITHOUTADNSTING THE THERMOSTAT SLETTINGAND TOALL.OW RESTARTING WITHOUT RELIGHTING THE cm n T WATERLINE PILOTLIGHT C t� d a.. 16.3 HEATED SWIMMING POOLS SHALL BE EQUIPPED WITH A POOL COVER(EXEMPTED FROM THIS REQVIREMENTARE OUTDOOR POOLS �L, Y c ro DlscTAv vNDlsn/RBED EARTii DERIVING 209 OF THE ENERGY FOR HEATING FROM RENEWABLE SOURCES AS COMPUTED OVERAN OPERATING SEASON) � c i m m DRY ,• 16.4 TIME CLOCKS SHALL BE INSTALLED 50 THE PUMP CAN BE SETTO RUN DURING OFF-PEAK ELECTRICAL DEMAND PERIODS AND CAN BE SET CD } = '•� a. TO RUN THE MINIMUM TIME NECESSARY TO MAINTAIN THE POOL WATER 1N A CLEAN AND SANITARY CONDITION LAW APPLICABLE 3/8'REBAR,C2)TYP. • C c m m n m DIVER7� SANITARY CODE OF NEW YORK STATE, .� D rp c VALVE O 3.SO0 PSI POURED cm cd CONCRETE 17. THIS DRAWING 15 FOP 5TPVCTURAL5HELL ONLY.ALL ACCES50RIES AND APPURTENANCES ARE DEFINED BYOTHERS. = E c 3 VINYL LINER •'•• C p 4L v 1S. BACKFILL WITH CLEAN EARTH,FREE OF ROOTS AND DEBRIS. DO NOTALLOW THE HEIGHTOF BACKFILLTo EXCEED THE HEIGHTOF THE W FILTER 2•T04•SAND • Y m N WATER IN THE POOL BY MORE THAN 8', OR THE WATER TO EXCEED BACKFILL BY MORE THAN 8- c F -� 19. PLACE CONCRETE ON SANDY TO LOAM SOIL REMOVE ANY CLAY DEPOSIT AND REPLACE W/COMPACTED CLEAN BACKFILL Q: L c 'ro R kNS 20. THERE IS NO MAIN DRAIN IN THIS POOL SUCTION FOR POOL WATER CIRCULATION 15 PROVIDED BY THE SKIMMERS ONLY.THIS MEETS 0 0 CHECK VALVE REQUIREMENTS OF THE NYS RESIDENTIAL CODE-SECTION R328S.1 FOR ENTRAPMENT PROTECTION. PLUMBING SCHEMATIC 21. THE POOL WAS DESIGNED LAW THE FOLLOWING: VAi_ ' V N.T.S. WALL 5 ECTI O N 21.1. THE NEW YORK STATE RESIDENTIAL CODE-SECTION PS28(2025) "� ' 21.2 THE NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE-SECTION R404.9(2025) _QImoS y N.T.S. Z3. THE NEW YORK STATE FUEL GAS CODE(2025) 21.4, THE NEW YORK STATE SANITARY CODE. 3 Oe 215. ANSI/APSP/ICC-5 STANDARD FOR RESIDENTIAL IN-GROUND SWIMMING POOLS. 21.6. BOCA CODE-SECTION 421. 21.7. CODE OF THE TOWN OFSOUTHOLD. 22 ALL BACKWASH TO BE SELF-CONTAINED ON-SITE } y.a �O. 08z y i 1.Copyright 2026,Alphonse Pesce Jr.,Co.,Inc.Land Surveying,All Rights Reserved. 2.Unauthorized alteration or addition to a survey map bearing a licensed land surveyor's seal is a violation of section 7209,sub-division 2,of the New York State Education Law. 3.Only boundary survey maps with the surveyor's embossed seal are genuine true and correct copies of the surveyor's original work and opinion. 4.Certifications on this boundary survey map signify that the map was prepared in accordance with the current existing Code of Practice for Land Surveys adopted by the New York State Association of Professional Land Surveyors;Inc.The certification is limited to persons for whom the boundary survey map is prepared,to the title company,to the governmental agency,and to the lending institution listed on this boundary survey map. 5.The certifications herein are not transferable. 6.The location of underground improvements or encroachments are not always known and often must be estimated.If any underground improvements or encroachments exist or are shown,the improvements or encroachments are not covered by this certificate. 7.The offsets or dimensions shown from the foundation to the property lines are for specific purpose and use and therefore are not intended to guide the erection offences,retaining walls,pools,planting areas, t addition to structures and any other construction. CENTRAL DRIVE N86000'30"E 75.00' o � C i� •N .--I M M '� O GA E 20.4' o! I k6 0.8'E L OPEN PORCH GARAGE ' '� I L_ =1-I-I-I-I-!-!-I-I-I-I-I-I-I-!-I-I-I-I-Ii 34.5 O� i 35.1' o 0 o- GATE r, L WOOD FENCE 3.6'E M+i � rrss1� 2 STORY cam'' FRAME o i DWELLING " Q BASEMENT ,I ENTRY 1.0E 55.1' j w LJS2 3 r'` RAISED ` J�+.JwwWOOD DECK0cOCM a 0' e0n' C�j /C� 40.0' 10.2WW Q yrV.�N w o PROPOSED� co IN GROUND SHEDO POOL,,..✓✓ 11Z U2li1 U v ° 0' 8.1%V 0.5 N vv O m 0.8N 84%V 10.3'W 1.41F to 1.5 E •� WOOD FENCE N S86000'30"W 100.00' TOTAL LOT 11,865.87 SQ FT or 0.27 acres AREA OF COVERAGE CALCULATION: House:1927 sq ft NOTES: Open Porch:245 sq ft -Non-visible easements,recorded or Deck:390 sq ft unrecorded are not shown. Sheds:200 sq ft -Underground foundations or Proposed pool:640 sq.ft substructures not visible are not shown. Total:3402sq ft or 28.7% SURVEY FOR LOCATION: 175 INLET DR, MATTITUCK OF NEW TOWN OFSOUTHOLD �1}? u�t�PPSrP, Jr. y COUNTY SUFFOLK, STATE OF NEW YORK Prof-miunal �ianh 3 urgor �'�Q SE PES�� LOT 143 ON MAP OF CAPTAIN KIDD ESTATES / Q N.Y.S. Lic. No.048365 Filed:JANUARY 19, 1949 Map Number: 1672 DIST.: 1000 SEC.: 106 BLOCK:2 LOT:23 5 CIRCLEDALE LANE SFOQ 04836`' SURVEY DATE:JUNE 27,2026 JOB:26-202 HOLBROOK, NEW YORK 11741 LAND =20' 718-486-5408 631-585-5317