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HomeMy WebLinkAboutTR-6954 , Jill M.Doherty,President *QF SO(/�yO Town Hall Annex James F.King,Vice-President ,`O �� 54375 Main Road Dave Bergen P.O.Box 1179 Southold,New York 11971-0959 Bob Ghosio,Jr. u> >e John Bredemeyer �O Telephone(631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 18, 2010 Mr. Thomas C. Samuels Samuels & Steelman Architects 25235 Main Rd. Cutchogue, NY 11935 RE: GREG & MARTHA CUKOR 7070 INDIAN NECK LANE, PECONIC SCTM#86-7-6 Dear Mr. Samuels: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., August 18, 2010: RESOLVED, that the Southold Town Board of Trustees grants a One-Year Extension to Wetland Permit#6954, as issued on August 20, 2008. This is not an approval from any other agency. Sincerely, Jill M oherty Presi ent, Board of Trustees JMD:lms 3. S A M U E L S & S T E E L M A N July 21, 2010 Southold Town Board of Trustees Town Hall Annex Main Road Southold, NY 11971 RE: RECONSTRUCTION OF THE CUKOR RESIDENCE 7070 Indian Neck Lane Peconic, NY 11957 TAX MAP # 1000-86-7-6 TRUSTEES PERMIT# 6954 Dear Sir/Madam: Please extend the existing permit referenced above for an additional one year. Enclosed you will find a check for$50. Please call us with any questions or concerns. Sincerely, �q� SAMUELS & STEELMAN ARCHITECTS C E V E j^ �► JUL 2 2 2010 f i 4 � Southold Toe,r. Board of Tru,-- Thomas C. Samuels, Architect enc. ARCHITECTS 25235 MAIN ROAD CUTCHOGUE,NEW YORK 11935 (631)734-6405 FAX(631)734-6407 James F. King, President �OF SU!/T�,o Town Hall Jill M. Doherty,Vice-President 53095 Route 25 Peggy A. Dickerson P.O. Box 1179Southold,New York 11971-0959 Dave Bergen G Q Bob Ghosio, Jr. Telephone(631) 765-1892 COU ,� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE —Z""P' re-construction, hay bale line 1st day of construction '/2 constructed Project complete, compliance inspection. 1�11 If IOjIIj..-� ..,`C 111 //.�i ..C\\1.1� •jr/'w. .gee•/� 1 /��„"'�. ;�I•1•11 �/%/,p: � ..,�`�h/��/rl�l%%i:..,f. ,••,`1�IP1�rrlr l�� c.�F :. i r �'f ��II Et N•I�i:�: BOARD OF SOUTHOLD TOWN TRUSTEES ,{ SOUTHOLD,NEW YORK PERMIT NO. 6954 DATE: AUGUST 20, 2008 ,,,�,: :'.:` ` q %•QI ISSUED TO: GREG& MARTHA CUKOR 11 PROPERTY ADDRESS: 7070 INDIAN NECK LANE, PECONIC �r\. _x aslll SCTM# 86-7-6 /1,►a•• r eiPP� � PI'/gi r AUTHORIZATIONrtl on"I.-i lwl Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on /,a _ August 20,2008, and in consideration of application fee in the sum of$250.00 paid by Greg&Martha Cukor and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees •�11 v, authorizes and permits the following: Wetland Permit to demolish the existing dwelling and construct a new dwelling f and garage,with the conditions of the new dwelling is moved back to measure 100' feet 1111,1 from bulkhead, a line of staked hay bales and silt fencing are installed prior to construction,the installation of a 10' Non-Turf Buffer area along top of slope, remove ,=11 as few trees as possible within the area of construction,the installation of gutters, 3 c r leaders and drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water Runoff, and as depicted on the site plan prepared by Samuels & Steelman Architects, last dated August 14, 2008, and received on August 14,2008. ,•,•1„• '1 IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, \S 11 and these presents to be subscribed by a majority of the said Board as of this date. +` ; �gUFFQ1��, ,•,,,1 M1' ' All 44 s / ' � � N•ti ..� ;u, .i../.l ♦i: . .� j�I� ,I.,Y,5i .., , •L . -,..��1,� /i,,1,�e1\ . QQL / ,1� 'r �Qr: ,�i��� fiA� u°.}.A�• ..>f 'r.... eau �'"-.: {'i .5'�' Orr li •RI• 4 i TERMS AND CONDITIONS The Permittee Greg&Martha Cukor, residing at 5913 Meadowood Road,Baltimore,Maryland 21212 as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will,at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved,but should circumstances warrant,request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required,upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Department of Real Properties Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90) calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. James F.King,President QF SOUTy� Town Hall Jill M. Doherty,Vice-President ,`O l0 53095 Route 25 P.O.Box 1179 Peggy A.Dickerson Southold,New York 11971-0959 Dave Bergen Bob Ghosio,Jr. �Q Telephone(631) 765-1892 �y CDUM`I, Fax(631) 765-6641�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 20, 2008 Mr. Thomas C. Samuels Samuels & Steelman 25235 Main Road Cutchogue, NY 11935 RE: GREG & MARTHA CUKOR 7070 INDIAN NECK LANE, PECONIC SCTM# 86-7-6 Dear Mr. Samuels: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, August 20, 2008 regarding the above matter: WHEREAS, Samuels & Steelman, on behalf of GREG & MARTHA CUKOR applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated July 7, 2008, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 6 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the new dwelling is moved back to measure 100' foot from bulkhead, a line of staked hay bales and silt fencing are installed prior to construction, the installation of a 10' Non-Turf Buffer area along top of slope, only remove as few trees as possible within the area of construction, the installation of gutters, leaders and drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water Runoff, and 2 WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on August 20, 2008, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of GREG & MARTHA CUKOR to demolish the existing dwelling and construct a new dwelling and garage, with the conditions of the new dwelling is moved back to measure 100' feet from bulkhead, a line of staked hay bales and silt fencing are installed prior to construction, the installation of a 10' Non-Turf Buffer area along top of slope, remove as few trees as possible within the area of construction, the installation of gutters, leaders and drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water Runoff, and as depicted on the site plan prepared by Samuels & Steelman Architects, last dated August 14, 2008, and received on August 14, 2008. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $ 100.00 Very truly yours, ames F. King President, Board of Trustees JFK/eac James F. King, President *oF so�Tyo Town Hall Jill M. Doherty,Vice-President ,`O l0 53095 Route 25 P.O. Box 1179 Peggy A. Dickerson Southold,New York 11971-0959 Dave Bergen G Bob Ghosio,Jr. ��ly� �@ Telephone(631)765-1892 04UNT11 Fax(631) 765-6641 � BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: �(� oar)-ka- Q Please be advised that your applic i ation dated �T (:Poor has been reviewed by this Board at the regular meeting o ao Apo and your application has been approved pending the comp tion of the following items checked off below.; Revised Plans for proposed project 4Pre-Construction Hay Bale'Line Inspection Fee ($50.00) 1st Day of Construction ($50.00) Y2 Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ /G� ✓ V"' D 9�a3 BY: James F. King, President Board of Trustees Donald Wilder,Chainnan CA Town Hall,53095 Main Rd. Lauren Standish,Secretary y, P.O.Box 1179 $' Southold,NY 11971 Telephone(631)765-1892 P� y` Fax(631)765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., August 13, 2008, the following recommendation was made: Moved by James Eckert, seconded by Don Wilder, it was RESOLVED to SUPPORT the Wetland Permit application of GREG & MARTHA CUKOR to demolish the existing dwelling and construct a new dwelling and garage. Located: 7070 Indian Neck Lane, Peconic. SCTM#86-7-6 Inspected by: James Eckert The CAC Supports the application with,the Condition of a 10' non-turf buffer, the installation of a pervious driveway, and efforts are made to save as many trees as possible, and a planting/landscaping plan is submitted. Vote of Council: Ayes: All Motion Carried SURVEY OF PROPERTY N 51TUATE: PECONIC PARKER'S LANDING TONN: 5OUTHOLD W � E 5UEEOLK COUNTY, NY SURVEYED 05-16-2006 Hn�1Lan Neck Road S 5UFFOLK GOUNTY TAX # Stone Mon. at N.E. Corner of Land Fromerly edge of pavement 1000-86-1-6 of Potrfdo D. Guinan N89021'30"E 132.50' CERT =TO: 1564'± Greg Oukor �o ed9 e op pot", eat ` I \ I \ ` I 9� 1 , �Jpo 17, s ` tI> s Lpo , fi , \ o \ o 1 1 1 1 I 1 1 1 I I I I I I 1 1 I 1 I I I I I 1 1 1 / I eO I l I I �p. Q 1 ! 1 1 I 1 S5 O 1! II l�l G Q I m l Q) IE I o ! 1 1 / 61, 1 1 1 I 9 1` Qi• 9 2 1 ( c ! 1 I 1 s-7, I 1 h I 1 o I I 1 0 I , I , O ` I I o 1 I, I 0- s< o,a 1 al [.L JUL - 7 LuuU p3,W 11 NI � 9 t o At 1 � o 1 Q� > ob,E o �,�of� � �I/� �p O N� Boa d o f roso n \ 1 � od 05, od NOTE5: o �� '� l \3 F.• 'Vnduthorlled alteratlon or oddlHon to a '� �� l`I�_ d� P map xaring a ncensed Imd a veyora aeal lea STAKE FOUND P ,Z 101atlon of eecte.Y' m eWdNslon to L the ;'..•.j (_� .j New co k sta a Ed anon Law F a�Q�� J � "tartly coplea from the orl ld of this wrveay 1f•' \ m ked wI -orgmal a 'o,and wrveyor ■ MONUMENT FOUND �'b }, A Dtamped seal shall be sorrel"-d to off valor trw ��. "Gertlflcotlone mdleated hereon algnRy ihat thle O�..J! _\O'G 17'-y't, survey waa prepared In o-ordance wlth tM ex- (� Y !Vv i/ skmg Code of Practice for Lord Survey,adopted /. bj or New York State Association of 1holiProfessional ' Lord the pe,on fork—he'cw'we ey prepared, J L and on his behalftothe thla company,qa ernmen- AREA = 126,850 S.F. or 2 A 13 Acres OOj tal agency and leno ing m,k�kutlon lAtea ereon,and to the oaeI,.ai the lendlrg m,tnuUon. GerLNlca- "ona or no, trareferable to additional IrotltuNane JOHN C. EHLERS LAND SURVEYOR GRAPHIG SGALE I"-50' 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287 REF:\\Compagserver\pros\06\06-175.pro 0 50 100 150 s�ea�xr�s�.a•+vao,m�l.,rv,rY ro.�oa�da-Ingo REVISIONS m 0BWDEMOLLIis E �S mEST HOLE BY McDONALD GEOSCIENCE HOUSE TEST HOLE DATA ( 4/10/08) 11 E D" T A" NOT TO SCALE GRADE ELEVATION + 72.0 FT. SCTM # 1000-86-7-6 3 FT. BROWN SILTY SAND SM PROPERTY: 7070 INDIAN NECK LANE ADDRESS PECONIC, NY PALE BROWN FINE TO OWNER: GREG & MARTHA CUKOR MEDIUM SAND SP 5913 MEADOW ROAD 17 FTj BALTIMORE, MD 21212 >_ NO WATER ENCOUNTERED Z SITE: 126,880 sf= 2.913 ac ZONING: R-80 Ith (5 Z BUILDING WALL GRADE LINE ELEVATION +/- 22'.O FT. --- __ :'�: � - V FF ELEV +25.0 I' MIN. 2' MAX. SURVEYOR: JOHN C. EHLERS W 6 EAST MAIN STREET; i ��� I �' I/4 /FT. I/8"'/FT. T� OF POOL ��� i RIVERHEAD, NY 1196"), AU , 14 c-03 SEPTIC LEACHING 20.0 FT. 4 2008 LICENSE# 50202 "�� t� TANK Q POOL 5/16/06 IE. +20.51 IE.+ 11�1.15 BO OM OF u m So � 4`i'�4.:t Teon � rnnordTO IE.+20.25 IE.+� Ici.67 = PO L 5.0 FT. Board rust.., of Trustees _V 28 ft 8 ft. MIN. 17'-011 Z m No �ATER 0 SEPTIC PROFILE ENCOUNTERED Edward D. Dart Judy L. Dart V GROUND WATER y W _ drive wy .J / a9 IONIC[ z %�r '/i'%,:;, ' PROJECT SITE Q Z y {j. NELL '`f EDGE OF 5ALTWATER 06 Z• NSF r : : v WTLANp5 A� ,.ETERMINED / Ste anie & Ste hen S. i shell BY EN-CONSULTANTS, INC., Q• C N/F High House Woods Inc. P Judy Dart �` ON JUL`� 1 I, 2005 pp I I Ikhe d W Z W set u ��aterllne a = LL S23 44 30 E l 1006. 55 AGN'�ITA : Ur : ,�� ex�5 g, 2 W• N OG TION HAY BAL 4 51 T �,��; �s ;' I Q F-• �O FENCE BA IER fi 1;�,�� ,!ri CO) U• p URING CON TRU ION _ �� (y' � — R�PaSEfT L d — -�- � of ►� G 1 N Q- o L I �/ ^7 ISO FEE AGH�N�' I TTL o '� ITARY LE �u5 EXISTING WEL TO \ ' �� ---------� _ �� o ^� NOLS FOUND �N1TH,N R BE ABANDON D \�\ `�: < _: i 1 Q PEGO I G VA^ p° PROPOSED F UP, (4) \ \ 1 `'� 11 3A1' F r, BEDROOM R 51 DENGE "�`` � f �►, � , 1 PEE `' 1�1 11' P�I 11 D 1 EX 1ST I N o PRO OSED +22.0 :,.� I I ? •111; pl`,� ` 1 ff) WOO C IIII 10 \ ` -- I I 11 j 1 ,;�,1 :�Pr7 5TA I S TO R� L — —1 I ►W'�; ; REM,)I N .lM1 OUN ND V�ELL -1 wood _fence _ , ,z : �,I;'1, i ` ' VLO FI1F Ft:� \� f » > N 2n fenc 4 / ea 0 W '..... wood fence 5 4 2. 4 ;" `� N 23°42 40 W 531 .08 1 EXISTIN f ti:N PROJECT NO: { FOO RIN (6ho'wn clotte�I) 0711 0 o NEIGHBORING WELL OF E 15TIN RE IDENCE TO l h , �:: .;f ;'� DRAWN BY: �` �� ti BE DEMOL I HED °tea,e SAN I TARP ... 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'�1.-P. - _ ��.. - .,�i�h. `lrxE..�c'�',Ir a "aya• 7'. •` rFY`@l� •�� � vs:.. a"'J• . .. 1 � I 0 � / 13/200� 13 09 e osuFFoc,� James F.King,President �p� CpG P.O.Box 1179 Jill A Doherty,Vice-President S Southold,NY 11971 Peggy A.Dickerson Telephone(631)765-1892 Dave Bergen Fax(631)765-6641 Bob Ghosio,Jr. Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: / a GREG & MARTHA CUKOR request a Wetland Permit to demolish the existing dwelling and construct a new dwelling and garage. Located: 7070 Indian Neck Lane, Peconic. SCTM#86-7-6 Tye of area to be impacted: V Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Par-of Town Code proposed work falls under: _Chapt.275 Cha�pt. 1�11 other Type of Application: '✓ Wetland _Coastal Erosion _Amendment Ad min istrative_Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Present re:__King 1/J.Doherty L-P.Dickerson '--�Bergen 0- Ghosio, Y D. 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SAllcl y T5p I.1dlc1 l]0 YtD 11 S i.; C $Y p • l ll c C s_3 m x0 E ve.F H0. ry 6 O _ ..L)l l.11 4 4]lIU i rG'� 1 .71 6 E b% ?t] �acl • yTB4 1,9 O S� �FpIJ 1 plJ 1 le.) lv. ]S JPpwt J o..v?4 4•to� :? LNEy c .s.3Fn, e.2 112 SEE SEC. 096 D � 6 LIE zva8 ueTCN -Y"E 'yam ^ SEE SEC.M.09e SEE SEC.N0.096 / c a[ , COUNTY OF SUFFOLK © K pX° SOUTHOLD SECTION NO ) Real Property Tax Service Agency : D 086 ,6allui orT:H PaTI�of ESE Emmv veneer Riverlva#N Y )190I S A M U E L S & S T E E L M A N O August 14, 2008 AUK Southold Town Board of Trustees 74 2408 Town Hall Annex Main Road Southold, NY 11971 ea�d°�°�uster? RE: RECONSTRUCTION OF THE CUKOR RESIDENCE 7070 Indian Neck Lane Peconic, NY 11957 TAX MAP # 1000-86-7-6 Dear Sir/Madam: Please note on SITE PLAN existing residence to be demolished is shown with a dotted line. The proposed house is located approximately 34 feet landward of the existing residence, in accordance with required setbacks from bulkhead and wetlands. For your review we are submitting the following documents: 1. (3) SITE PLANS revised to emphasize demolished structure Please call us with any questions or concerns. Sincerely, SAMUELS & STEELMAN ARCHITECTS Thomas C. Samuels, Architect enc. ARCHITECTS 25235 MAIN ROAD CUTCHOGUE,NEW YORK 11935 (631)734-6405 FAX(631)734-6407 z i OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex P.O.Box 1179 54375 State Route 25 ��g�FFO(�-co Southold,NY 11971 Main Rd.&Youngs Ave. �O G,t Telephone:631 765-1938 Southold,NY 11971 Fax: 631 765-3136 0 y Z LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: Jim King,President i C Town of Southold Board of Trustees S 1 From: Scott Hilary and Mark Terry,LWRP Coordinators AUG 20 2008 11�" Date: August 13 2008 —� ---1 Southold To��n Board of Trustees Re: Chapter 268,WATERFRONT CONSISTENCY REVIEW Wetland Permit for GREG&MARTHA CUKOR SCTM#86-7-6 Samuels& Steelman on behalf of GREG&MARTHA CUKOR requests a Wetland Permit to demolish the existing dwelling and construct a new dwelling and garage.Located: 7070 Indian Neck Lane,Peconic. SCTM#86-7-6 The proposed action has been reviewed to Chapter 268,Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program(LWRP)Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is our recommendation that the proposed action is INCONSISTENT with LWRP policy standards and therefore is INCONSISTENT with the LWRP. Policy 6 Protect and restore the quality and function of the Town of Southold ecosystem. 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The distance from the natural protective feature,bluff(as defined in 4 275-2)to the proposed action,is approximately 40 feet; a minimum setback distance of 100 feet from the bluff line(as defined in &275-2)is required pursuant to Chapter 275- 3.Findings; purpose; jurisdiction; setbacks.Please require that the applicant amend the proposed action to meet the above policy to the greatest extent practicable. §275-2 Definitions, word usage. BL UFF --Any bank or cliff with a precipitous or steeply sloped face adjoining a beach or a body of water. The waterward limit of a bluff is the landward limit of its waterward natural protective. Where no beach is present, the waterward limit of a bluff is mean low water. The landward feature limit is 25 feet landward of the receding edge or, in those cases where there is no discernible line of active erosion, 25 feet landward of the point of inflection on the top of the bluff. The point of inflection is that point along the top of the bluff where the trend of the land slope changes to begin its descent to the shoreline. BLUFF LINE -- The landward limit c`- 'duff that is 25 feet landward of the rece " edge or, in those cases where there is no discernible line of active erosion,25 fe ndward of the point of inflection on the 9f the bluff. The point of inflection is that point along the top of the bluff where the trend of the land slope changes to begin its descent to the shoreline. §275-3 Findings,purpose,jurisdiction;setbacks. C. Jurisdiction: The following areas are subject to protection under Chapter 275 of the Code of Southold. [Amended 10-11- 2005 by L.L. No. 17-2OO5] (1) Any freshwater wetland, tidal wetland, beach, bluff, dune,flat, marsh, swamp, wet meadow, bog, or vernal pool; (5) Land within 100 feet of the areas listed above. D. Setbacks. [Amended 10-11-2005 by L.L. No. 17-2OO5] (1) The following minimum setbacks apply to any and all operations proposed on residential property within the jurisdiction of the Board of Trustees: (b) Bluff line. [11 Residence: 100 feet. [2] Driveway: 100 feet. [3] Sanitary leaching pool(cesspool): 100 feet. [41 Swimming pool and related structures: 100 feet. r . - �1131�0� A. } ooQ soo 0811312M 13:08 Itx�' If tht Agency,Board of Trustees mal'__ contrary determination of consistent, Agency shall elaborate in writing the basis for its disagreement with their recommendations Pursuant to Chapter 268 Waterfront Consistency Review. §268-5. Review of actions. H. In the event the LWRP Coordinator's recommendation is that the action is inconsistent with the LWRP, and the agency makes a contrary determination of consistency, the agency shall elaborate in writing the basis for its disagreement with the recommendation and state the manner and extent to which the action is consistent with the LWRP policy standards. Pursuant to Chapter 268,the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Albert J. Krupski, President �O%VFQt/( Town Hall James King,Vice-President ��� �G� 53095 Route 25 Henry Smith c P.O. Box 1179 Artie Foster vJ = Southold, New York 11971-0959 Ken Poliwoda �y� Telephone(631)765-1892 Ol �.a0 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Voastal Erosion Permit Application etland Permit Application Major Minor _Waiver/Amendmen C an es eceived Application: 77 or d_Received Fee:$ V t/Completed Application 0909 D �' Incomplete Q _SEQRA Classification: Type I Type II Unlisted 'JUL Coordination:(date sent) 2008 _✓CAC Referral Sent:' ( Cj' _/bate of Inspection: ( I;'3�o BOardSouthhold Qf Tr�rt eJ _Receipt of CAC Report: _Lead Agency Determination: Technical Review: . .Public Hearing Held: v _Resolution: Name of Applicantk.�G Address 521.3 /ylE,¢pyW V341% 114D 2 7,12. Phone-Number:( ) LZA10 2q[ Q ?&4 G Suffolk County Tax Map Number: 1000 - Property Location: 7D?o 1,1r'DW erie,AZ U&_i ' A&ncoM,U J'!2M -T[Pt 26 D, M 9 3C. 600 Pr, &zX bid CVO (provide LILCO Pole#, distance to cross streets, and location) AGENT: T oln &f'yI oaj— (If applicable) Address: ) Phone: Board of Trustees Application GENERAL DATA q Land Area(in square feet): �oG bo Peo Jr Area Zoning: ^ CPA Previous use of property: 6 Intended use of property: tii�lPi Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description(use attachments if necessary): � s E( sri T U MM Was M!D Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: © square feet Percent coverage of lot: % Closest distance between neare t existing structure and upland edge of wetlands: (,, l� feet Closest distance between pearest proposed structure and upland edge of wetlands: u ff feet Does the project involve excavation or filling? No V Yes If yes, how much material will be excavated? SDD cubic yards How much material will be filled? JdM r cubic yards Alf a< 1�rf LL Depth of which material will be removed or deposited: feet IT00A1447'fOU Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): di'o c7~• 1.4-16=4(2/87)—Text 12 • PROJECT I.D.NUMBER 617.21 S EQ Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I—PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT/SPONSOR 2. PROJECT NAME G�EG- .9 /!9/�lery14 3. PROJECT LOCATION: Municipality OneCounty 4, PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) 7070 ®nV/fin/ Ale-V& 41,f F7 i910MoNl Eva r'r• M95T r 5. IS PROPOSED ACTION: P. ❑Expansion ❑Modification/alteration S. DESCRIBE PROJECT BRIEFLY: AC1_00ZWSdV 7. AMOUNT OF LAN FFECTED: Initially �2 acres Ultimately Z acres 3. WILL/ LPROPOSED ACTION COMPLY WITH EXIST ING ZONING OR OTHER EXISTING AND USE RESTRICTIONS? UG Yes ❑No If No,describe briefly 9. WHAT �IS PRESENT LAND USE IN VICINITY OF PROJECT? UQ Residentlal [Industrial ❑Commercial ❑agriculture L_ Park/Forest/Ooen space Other Describe: • i 10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING, NOW OR ULTIMA T ELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL, STATE OR LOCAL)? LrI Yes ❑No If yes,list agency(s)and permitlapprovais 141g1S1062_i, JYC,p eX ,ro4r-17t&0 ll. DOES ANY ASPECT OF THE ACTION HAVE A.CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes' ENO if yes, list agency name and per 12. AS A RESULT OOF,PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? ❑Yes I CERTIFY THAT THE INFORMATION!PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: ' „ey ✓ sr Pz= - � r �^U Date: O� Signature: J`9,ww L.4 If the action is in"the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this as§essment OVER PART II--NVIRO'NMENTaE SNI-ENT be ccr;cietac! by Ayen.. 40 A. LL.CES AC :CN =XCcco� .NNY : -E i H;i'ES'r.CL3 :N 3 NYCRR. ?.4nT�:7.'2? it yes. cocraina'Ce me renew -rocess ana usa the FUL_ _x>P. 7,eas I,—:NO a. WILL ACTION RECEi`/=_CCCROINATED REVIEW AS?RCVICED=CR UNUSTEU•,C-.jCNS iN 3 NYCRR. ?ART 5,,.3? it No. a negative aec:ara may be sucersedea oy another;nvolved agency. L✓Yes Zi No C. CcUL0 ACTiCN RESULT:N ANY ADVERSE EFFECTS ASSCC:ATcJ WITH - E FOLLOWING:fAnswers may oe handwritten, it :egiblet 1-1. Existing air quality, surfaca or'grounawater quality or quantity, noise revels. existing :caffic -atzerns. solid waste production or clscc potential for erosion, grainage or:Icocing problems?E:plain briefly: C2. Aesthetic,agricultural, archaeological,historic,or other natural or cultural resources:or.community or heignberncoo character? =xolain �r CS. Vegetation or sauna. 'Isn. snellfisn or wildlife species, significant haoitats,or threatened or enaangerea _cec:es? _.:clam orlatly: C;. A community's existing plans or goals as offic:ally adooted,or a cnange in use or intensity of use of land or other natural resources?Explain or C5. Growth, subsequent :evelooment.or related activities likely to be induced by the orebosea action? =xotain oriefly. Ca. Long :erm, snort term-cumulative,or other effects not identified in C.-CS? =xotain briefly. i i ) C 7. Caber;moats Onc;ucing c:^anges in use of either quantity or :ype or energy)? °:oiain griedy. I I , I 1 'C. ;S 7r(ERE.CR iS THERE _:Kc'.' -0 3E.CONTROVERSY R'LATEO M POTENTIAL ACVEFISE ENVIRONMENTAL:i:PACTS? i 'Yes _NO if'!es, exclain orrefty PART III-01E ERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS. For esen adverse effect identified above,determine whether it is substantial,large. important or otherwise signific Each aifect should be assessed in connection with its (a) setting (i.e. urban or rural); (b).probability of occo.irtg; (c) duration irreversibility:(e) geograonic .3cope;and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure explanations contain sufficient dezait to snow that all relevant adverse impacts have been identified and adequateiy addressed. i Chec% this box if you have Identified one or more Potentially large or significant adverse impacts whic.1 '.1A': occur. Then '6roceed directly to the FULL EAF and/or prepare a positive-declaration. i Check this box if you have determined, based an the information and analysis above and any supoortinc documentation, :hat the Proposed action WILL NOT result in-:pny significant adverse environmental imcac:: AND provide on attac.iments as necessary, the reasons SUCCOrting this determination: I I I .N„tire m read Agency i ?nnt ur :vpe game 31 laeoon%iole�1tnc_r:n Luao Agt:nCv title or rLc:condole oir.cer I i ;r4nature 91 lescontaale'_iniar in %eaa Agency S-gndture or r•'R:]drer tir dli:erear :ram re5o0a5101e onicen i Dice 2 Board of Trustees Application County of Suffolk State of New York �• BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. 9 Signature SWORN TO BEFORE ME THIS DAY O N tary Public Notary u�lc M. of New York No.OIST6164008 Qualified in Suffolk County Commission Expires April 9,2 Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) residing at (print owner of property) (mailing address) � G7`�l�1D/���r ffij f 2 do hereby authorize (Agent) 0/��� C • U �r to apply for permits) from the Southold Board of Town Trustees on my behalf. (O is signature) . PROOF OF MAILING OF NOTICE ATTACH'CERTIFIED MAIL RECEIPTS Name: Address: pA Iq 7(o y 9 � ► ,q&r)� Lo vtn Vo)vn+Wa&64)i rb on K)y 11 q cS STATE OF NEW YORK COUNTY OF SUFFOLK residing at LAO 69—� bein duly sworn, deposes and says that on the _day of ,20 deponent mailed a true copy of the Notice set forth in the Board o Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold;that said Notices were mailed at the United States Post Office at that said Notices were mailed to each of said persons by (certified. (registere mail. Sworn t before me this l � � Day of S T,20 6 r V "X N t Public WENDY L. KUKLA Notary Public,State of New Yotk No.01IGJ6176871 Clueilfled In Suffolk County Commisslon Expire I11MOII James F. King,President SUUry Town Hall Jill M. Doherty,Vice-President ,`O� Ol0 53095 Route 25 P.O. Box 1179 Peggy A. Dickerson Southold,New York 11971-0959 Dave Bergen G f �� Telephone(631)765-1892 Bob Ghosio,Jr. �000U Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) c _ ' c AFFIDAVIT OF POSTING I, I i I cS -X�l�yi y�IJ, residing at 770�� �� �2d �-J being duly sworn, depose and say: That on the K day of ft!�VS , 2001K, I personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held ' _ 01a. 020 , 01-W -'' Dated:/lq`() G (signa re) Sworn to before me this 'q day of/h j g[200 9— r Notary Public PATRICIA PICHARDS Notary Public, State of New Vork No. 01 R16042467 Qualified in Suffolk County Commission Expires May.30, _\ APPLICANT TRANSACTIONAL DISCLOSURE FORH 1 The mown of Southold's Code of Ethics: Ofohlbibs conflicts of me Beat on the part of town officers and employees. The Our ose of this form is topro-vide information which can alert the town of possible conflicts of interest_ and allow it to take whatever action is necessary to avoid same. YOUR NAHE s (Last name, first name,middle inibialp 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. ) NATURE OP APPLICATION: (Check all that apply.`) Tax grievance Variance change of zone ' App Wal of plat ;h Exelption from plat or official map other (If "other," name the activity. ) Do you personally (or through your cbmpany, npbutle, nibiing, 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" ;Weans 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 " .:a, If you answered OYES,". complete the balance'of this form and date and sign where indicated. Name of person employed by the Town or Southold Title or position. of that person Describe the relationship between yourself (the applicant) and the town officer or employee. Either check the appropriate line h) 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)t A) the owner of greater than 594 of the shares of the corporate stock of the applicant (when the applicant is a corporation)l b) the legal or bbneficial owner of any interest in a noncorporate'entity (when the applicant is not a corporation); c) an officer, director, partner, or emplbyee. of the appiicanti or D) the aptual•applicant. DESCRIPTION OP 1tELATIONSHIP submitted thIaixL. diy signature... -Print namew � •. ,: : . :nl;is 8y 4 .a.• :•j'.•:�F • .'•.a•�'i!,.. ',ir t:•{,.t'I7�kFN%r1•A1.. ,�,.�;:;.1 Town of Southold a LWRP CONSISTENCY ASSESSMENT FORM 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" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non supporting facts. 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# 8 6 - 07 - 06 PROJECT NAME RECONSTRUCTION OF THE CUKOR RESIDENCE The Application has been submitted to (check appropriate response): Town Board 0 Planning Board 2 Building Dept. 0 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) 0 (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval,.license, certification: Nature and extent of action: Demolition od existing .residence and abandonment of existing sanitary system, and construction or new two s o y e with sanitary system and new garage ih conforming locations Location of action: 7 07 p Ind t t k Algek laotp vrQfftc 0.7 0 Site acreage: 126, 880 s f; 2. 913 acres Present land use: sin4le family residence Present zoning classification: R-8 0 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: Thomas C. Samuels (for Greg and Martha Cukor) (b) Mailing address: 25235 Main Road, Cutchogue, NY 11935 (c) Telephone number: Area Code( ) 7 3 4-6 4 0 5 (d) Application number, if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes 0 No❑ If yes,which state or federal agency? NYSDEC C. Evaluate the project to the following policies by analyzing how the,project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. 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. I Yes No Not Applicable rove beach and site. Most of the xi s preserved open space, and far less than the allowable 20% of the site will be developed. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6,for evaluation criteria 0 Yes E No F] Not Applicable There are no historic or archeological structures on the property. Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ® Yes 0 No 0 Not Applicable e new structure ts in keeptrig wtth the' suctle and style of Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. .Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ® Yes 0 No 0 Not Applicable All r'ai nw ter Y77 _4 s: and, wi 3 1 be retai nt-d on the si to with the—u.-se of »nderarn,in l c Dur; na construction hay bales will be placed between the? construciton and the shore, to keep runoff spoils on the site. ' Attach additional.sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria, ® Yes E3 No 0 Not Applicable no-f--f is and will be retain d witbin the and stem for the residence De t. of Health Services standards for ste water. The property is not 'served by pub is water systems, but the new well will be sited appropria e y. Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III — Policies; Pages 22 through 32 for evaluation criteria. Yes Di No Not Applicable Mn d v 1 opmentrYwi 1 1 take place in the "protected" or "indigenous Pnvironment-" Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ® Yes ❑ No❑ Not Applicable ThP development 'wi11 not add bolluntants into the air. All construction vehicles meet the Fedral standards for air pollution discharg. The mechanical systmes of the residence meet t e Fedral standards for air pollution discharge. Attach additional sheets if necessary 1 Policy 8. Minimize environmental degradation in Town of Southold from solid waste,and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ® Yes ❑ No ❑ Not Applicable e Tewn ' s disvpGSal and. rgnayciing renter. All waste water " d into an a roved SCDHS sanitary system. 1 PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP.Section III—Policies; Pages 38 through 46 for evaluation criteria. © Yes❑ No❑ Not Applicable s _unimpeded. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold'!#!der-dependent uses and promote "n. of new water-dependent uses in suitable locations. See LWRP Section III-Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable There are no public or commercial activities or uses on sa e. Historically this property ana neig oring prope rest en ai in use and wi . Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III-Policies; Pages 57 through 62 for evaluation criteria. ® Yes ❑ No ❑ Not Applicable living marine resources by maintaining all rainwater discharge and sanitary flow from the residence on site by approved SCDHS sanitary sytem and drywells for rainwater runoff. Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III-Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No® Not Applicable There- cEre. no crgrleul:tural -1a.-nds; an site - Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III-Policies; Pages 65 through 68 for evaluation criteria. © Yes ❑ No ❑ Not Applicable usincr equipment approved by the Fe ra gnmernment for energy usage. The residence will me- - standards for conserving energy "energy ar ro use "NY State Energy Conservation and constructi-on­-e-vtle- construction of tne rest e e PREPARED BY TITLE DATE Amended on 811105 S A M U E L S & S T E E L M A N July 8, 2008 Southold Town Board of Trustees E Q Town Hall Annex Main Road JUL Southold, NY 11971 7 2008 RE: RECONSTRUCTION OF THE CUKOR RESIDENCE 5outhhold row,, 7070 Indian Neck Lane Board of Trustees Peconic, NY 11957 TAX MAP # 1000-86-7-6 Dear Sir/Madam: We are requesting a Permit for the above reference project, for demolition of existing residence and construction of new residence, garage and sanitary system, all beyond the required 100 foot setback. For your review we are submitting the following documents: 1. Application 2. Short Environmental Assessment Form 3. Application Affidavit 4. (2) LWRP Consistency Assessment Form 5. (3) SITE PLANS prepared by Samuels & Steelman Architects 6. Current Survey 7. Letter of authorization from Owner 8. Check for$250 Please call us with any questions or concerns. If application is complete, please schedule a public hearing and notify our office about posting the site and notifying the neighbors. Sincerely, SAMUELS & STEELMAN ARCHITECTS Thomas C. Samuels, Architect enc. ARCHITECTS 25235 MAIN ROAD CUTCHOGUE,NEW YORK 11935 (631)734-6405 FAX(631)734-6407