Planning & Zoning Commission (linked)

Office Use Only
Town of Waterford
Department of Planning and Development Date Submitted:
Processed By;
www.waterfordct.org
App. No.:
Total Fee: $
PZC Form 1
Electronic Submission
Waived: Yes No
Planning and Zoning Application
| Type of Application(s), Use and Property Information (check all that apply)
im Informal Staff Review _]} Site Plan/Design Review im Municipal Project (CGS§8-24)
im Special Permit/Design Review! im Subdivision /Resubdivision O Lot line Adjustment
| Zoning Map Change im Regulation Amendment(s) im New District
O Multifamily Development _]} Coastal Area Management ? O Earth Excavation
_]} Flood Hazard Area im Other: im Other:
Specify all uses and corresponding section for which this application applies*:
Use, One-family dwelling 6A4.1
Section
Use: Section:
Use: Section:
Name of proposed development/subdivision: Na If subdivision how many lots?:
If applicable, are roadways proposed to be private, public or both:
(] Private L] Public [_] Both‘
Parcel 1 Parcel 2
Map/Block/Lot: m8) a / / Map/Block/Lot: / / / /
Street No. & Name: 2 Forest Street Street No. & Name:
Size SF/AC: 3,765 SF 0.0864 AC Size SF/AC: /
Zoning District(s): VR-7.5 Zoning District(s):
* Include a completed list of property owners with Parcel ID, name, address and mailing address. It is the applicant’s responsibility to distribute all
notices certified return receipt. Evidence of mailing shall be submitted prior to the start of the hearing. Failure to do so will delay the opening of the
hearing,
? Coastal Site Plan reviews under Coastal Area Management $25.4 must submit a completed PZC Form 2 in addition to this PZC Form 1.
5 The use listed must correspond to the exact use term noted within the zoning district as a permitted use allowed through site plan or special permit.
Ke plan must accompany the application clearly delineating the limits of public and private roads.

Name:
Title:
Company:
Address:
City/State:
Zip Code:
Telephone:
2. Applicant Information
Mikhail Yevsyuk
| 3. Agent Information; if applicable
Name:
Title:
Company:
Address:
City/State:
Zip Code:
Telephone:
4, Property Owner(s) and Parcel(s) Information
Gregg Fedus
Professional Engineer
Fedus Engineering, LLC
70 Essex Street #2c
Mystic CT
06355
Na
(860) 536-7390.
Applicant’s Authority to File Application®
i | Legal Owner of Record
Power of Attorney
Contract to Purchase
Other
Specify Nature of Agent
Attorney
HB) civil engineer
Land Surveyor
Design Professional;
Other:
Is owner co-applicant? im Yes [No
Note: If landowner is an LLC, Corporation, Trust or other legal entity, attach the names, addresses and title of each
member or officer, including agent(s). If same as applicant list ‘Same’.
Name:
Title:
Company:
Address:
City/State:
Zip Code
Telephone:
Fax:
Email:
Same
Same
Same Same
Same
Same
Same
Alexandra Yevsyuk
Name:
Title:
Company:
Address:
City/State:
Zip Code:
Telephone:
Fax:
Email:
5 Applicant must submit evidence attesting to the authority to file application (i.e. deed, option for purchase, etc.)

15. Statement of Use
Attached a typed statement of use in conformance with the Zoning Regulations as described in Section 22.4.2. In addition
include all hours and days of operation, size of buildings and number of stories, utilities servicing the parcel, variances
received, number of employee and structures to be demolished.
6. Statement of Design Compatibility (Site Plans and Special Permits only) |
Attach a statement describing how the building and site design is compatible with the neighborhood, character of
Waterford and Zoning Regulations.
Ts Consistency with Adopted Plan of Preservation, Conservation and Development (all
applications)
J
Attach a statement attesting to how the proposed use, zone change, amendment or design is consistent with the most
recent adopted Plan of Preservation, Conservation and Development (the Plan). Note relevant Plan section numbers and
pages.
Yes No % of Property
a. Are inland wetlands present on site? Total SF/AC /
c. Are their known or suspected vernal pools on the property?
)
O | b. Are tidal wetlands present on site? — Total SF/AC /
O @
O @
d. CT DEEP NDDB: Are endangered, threatened or species of special concern suspected to be located on
the property? Applicant must attach an 8 / x 11 map of the most current CT DEEP Natural Diversity
Database with site clearly identified regardless of response provided. If you answered yes to item d.,
attach a letter from CT DEEP stating the name of the specie(s) that are suspected to be on the
property. See Section 22 of the Zoning Regulations for additional information.
|_| e. Are floodplains or flood hazard areas on the property?
tdentify, Flood Zone AE-10
| | f. Is the property located within a local, state of national historic district?
If yes identify district name:
[J B g. Does the site possess any structures or sites listed on the local, state or national register of historic
landmarks?
If yes, identify:

Additional Information
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Se UUS BRE
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New London
Is any part of the site within 500' of the Town line? Which town:
Will any egress or ingress for the property use streets within an adjoining municipality?
Is any work proposed in wetlands or watercourses? Explain in Statement of Use
Is any work proposed within 100 feet of a wetlands or watercourse? Explain in Statement of Use
Is any work proposed within a floodplain or flood hazard area? Explain in Statement of Use
Waterford Utility Commission
Is public water available or proposed to the site? Identify:
2 i ‘ «-., Waterford Utility Commission
Are public sanitary sewers available or proposed to the site? Identify: y
Is there a utility, drainage or other easement(s) on the site? Specify:
Is open space proposed on the property?
How much open space is proposed (SF/AC)? / Percent of property(s)
Use and purpose of open space:
10. Previous Land Use Permits Associated with the Property(s)
Have previous permits been issued for the Property: [Byes O No (List singularly; attached additional pages if necessary)
Date Issued
01/04/2007
Issuing Agency Approved Use/Activity
Zoning Board of Appeals 6' from both side yard setbacks

| 11. Change of Zone, Regulation Amendment or New Zoning District, if applicable
Yes No
O B a. Is this application for a new zoning district and/or regulation not presently established within the
Zoning Regulations? If a new zoning district, distinguish type of zone proposed:
[_]rixed Zone
[_Jrtoating Zone
[_Jovertay Zone
Identify proposed zone name:
For new regulations, list proposed section number(s) and titles(s):
iii.
im & b. Is this application an amendment to an existing regulation? Attach proposed amendments, clearly
noting any deletions, modifications or additions. List sections proposed to be modified:
i.
ii.
iii,
C] | c. Is this application for a change to a district already established within the regulations? Identify:
Supporting materials:
For new zoning districts or a change in zone provide a legal description of the land involved in the zone district change
including the following:
* Location map at 1”=1000°
© Accurate description and acreage of tract(s) to be changed with existing buildings and uses
© Show existing features including but not limited to contours at two-foot intervals, wetlands and watercourses,
flood plains, all improvements and structures,
¢ All lots or parts of lots contained in an area within 500 feet in all directions of the zone change tract
¢ All lots shown in this area and within the zone change tract shall contain the name and address of owners as
recorded in the Assessor’s records and shall show the nature of use
* North point, and distance along road from nearest road intersection.
* Scale of map(s)

12. _ Bulk Zoning Requirements Table
Complete the following table, which must also be included on applicable drawings:
Zoning District(s):
Trem Required Proposed
Minimum Lot Size 7,500 SF 3,765 SF
Frontage 50' 45.91'
Front Yard 20.05' +/- 5' 15.5"
Side Yard 15° 9.75' E, 9.85' W
Rear Yard 30' 33.88'
Building Line Na 45.88'
Building Coverage 20% 19.9%
Parking® 2 2
Landscaping Na Na
Impermeable Coverage Na 19.9%
See attached
© Attach method used to determine the number of parking spaces required.

13. Planning, Design and Engineering Team
Provide a list of all professionals responsible for the project.
Civil Engineer
Gregg Fedus, P.E.
Discipline:
Name:
Saupiage Fedus Engineering, LLC
License(s)/ . :
Accreditations: Professional Engineer
Discipline: _ Telephone: —— ee
Name: _ Fax: =
Company: —_ Email:
Licenses and/or License/
Accreditations: Accreditation No(s):
Discipline: Telephone: _
Name: Fax:
Company: _ Email: __ _
Lice: and/or License:
Ac jitations: Accreditation No(s):
Discipline: Telephone:
Name: Fax:
Company: - Email:
Licenses and/or License:
Accreditations: _ Accreditation No(s):
Discipline: Telephone:
Name: Fax:
Company: Email:
Licenses and/or License/
Accreditations: Accreditation No(s):

14, Supporting Documentation
Itemize, including additional attachments, all information provided in support of the application. Titles, dates and
sheet/map numbers shall correspond exactly with the corresponding information provided.
y: [[] Yes _ho
"Site Plan of 2 Forest Street"
Prepared for: Mikhail Yevsyuk
October 9, 2025
Sheet 1 of 1
Additional pages attached, if neces
15. For Informal Staff Review Use Only
Sec. 7-159b — Pre-application review of use of property. Notwithstanding any other provision of the general statutes,
prior to the submission of an application for use of property under chapters 124, 126, 440 and 541 or any other provision
of the general statutes authorizing an authority, commission, department or agency of a municipality to issue a permit or
approval for use of such property, such authority, commission, department or agency or authorized agent thereof may
separately, jointly, or in any combination, conduct a pre-application review of a proposed project with the applicant at
the applicant's request. Such pre-application review and any results or information obtained from it may not be appealed
under any provision of the general statutes, and shall not be binding on the applicant or any authority, commission,
department, agency or other official having jurisdiction to review the proposed project
I have read and understand the above provision of the Connecticut General Statutes and understand and agree that
whatever discussion, comments and/or recommendations are made through this review are non-binding upon the parties.
Further, I acknowledge and agree that this pre-application review meeting is being conducted prior to and in anticipation
of a formal application to the Waterford Planning and Zoning Commission or Conservation Commission to obtain
feedback ani
response to the proposal or design, as it exists on this date, in the interest of preparing an application
consistent fith the Subdivision, Zoning or Wetlands regulations of the Town of Waterford as the case may be
Printed Name Date
Mikhail Yevsyuk W119 [ & 25-
Gregg Fedus 11/19/2025
Mikhail Yevsyuk YUL18] 2_e-
Mexaudva Veusyuk I 19 b05

16. Technical Assistance Review Fee
In accordance with the Waterford Code of Ordinance Chapter 16.08, the Commission may require third party techni:
assistance review for the evaluation of applications associated with but not limited to site plans, special permits, zone
change and regulation amendments and may collect payment for costs associated with the review. This includes but is not
limited to civil engineering, architecture, legal assistance, traffic engineering and environmental protection
Acknowledgements; All applications
ipplication Content
The undersigned herby acknowledges that this application and statements submitted herewith are true to the best of my
knowledge and approval of the application is contingent upon compliance with all requirements of said regulations
Right of Entry and Inspection
The undersigned hereby authorizes the Waterford Planning and Zoning Commission or its agents, to enter the subject
property for the purposes of inspection and enforcement for the said Zoning Regulations until receipt of final Certificate
of Occupancy and Certificate of Zoning Compliance.
Electronic Data Accuracy and Transmission
If applicable, the undersigned hereby acknowledges that all electronic data submitted as part of this application is an
accurate and true representation of all paper transmissions provided as part of this application and may be transmitted
publically when requested and all applicable fees are paid in full by the requesting party.
Signature Printed Name Date
Mikhail Yevsyuk Uf ¢/ 2E5
Gregg Fedus 11/19/2025
Mikhail Yevsyuk Uf [§ lees
Mexaudva Yeysyu k 1/19 [2025