HomeMy WebLinkAboutKumar, Ajit & Ecclestone, Jennifer Glenn Goldsmith,President �o��SVFFO(,�COL Town Hall Annex
A.Nicholas Krupski,Vice President y 54375 Route 25
Eric Sepenoski C2 ,? P.O.Box 1179
Liz Gillooly �y • 0N- Southold,NY 11971
Elizabeth Peeples �Ol Telephone(631)765-1892
Fax(631)765-6641
Southold Town Board of Trustees
Field Inspection Report
Date/Time: 3 12 2 Completed in field,by: ii.&6A Pe,e,T��.�
Anthony Portillo of AMP Architecture on behalf of AJIT KUMAR & JENNIFER
ECCLESTONE request a Pre-Submission Inspection to discuss the proposed
restoration/reconstruction of the existing framed cabana, deck, retaining wall, wood
walks and bluff stairs. Located: 1490 Paradise Point Road, Southold. SCTM# 1000-81-
3-20
Type of area to be impacted:
Saltwater Wetland Freshwater Wetland Sound Bay
Part of Town Code proposed work falls under: Chapt. 275 Chapt. 111 other
Type of Application: Wetland Coastal Erosion Amendment
Administrative Emergency Pre-Submission Violation
Notice of Hearing card posted on property: Yes No Not Applicable
Info needed/Modifications/Conditions/Etc.:
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Present Were: /G,?61dsmith /N. Krup ki v E. Sepenoski
L. Gillooly ✓E. Peeples
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AM P Architecture Address:10200 Main Road,Unit 3A,PO Box 152,Mattituck NY 11952
Phone:(631)603-9092
Design + Build
March 5, 2024
IAA - 6 2024
Re: Kumar Residence Pre-Submission Site Visit Southold Town
1490 Paradise Point Board of Trustees
Southold, NY 11971
SCTM No. 1000-81-3-20
To Whom It May Concern,
Please find copies of the site plan, owner forms,and application fee for the above address enclosed.
The owner and agent, AMP Architecture, would like to set up a pre-submission meeting with the
Trustees to discuss the following:
- Proposed restoration of frame cabana, deck, retaining wall, walk, &steps.
The following people will be attending the meeting:
- Anthony Portillo,AMP Architecture
After review, please let us know when the meeting is scheduled.
Please contact our office if you have any questions.
Thank you, i
Kyle Edstrom
Page 1 of 1
I
-_,oard of Trustes:s Application
AFFIDAVIT
Ajit Kumar& Jennifer Ecclestone _BEING DULY SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMITS) 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
BOARD OF 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,INCLUDING THE
CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO
INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION,
INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF
TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE
COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL
EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM
OF THE PERMIT.
Signature of Property Owner Signature of perty Owner
SWORN TO BEFORE ME THIS X2t f) DAY OF ` fit , 20 J--"
Notary Pu lic
KAMAL P.SONI
Notary Public,State of New York
No.01 S06089949
Qualified in Kings County
Commission Expires March 31,2027
,�oard of Trustees Application
AUTHORIZATION
(Where the applicant is not the owner)
I/We, Ajit Kumar& Jennifer Ecclestone
owners of the property identified as SCTM# 1000-81-3-20 _in the town of
Southold New York, hereby authorizes
AMP Architecture to act as my agent and handle all
necessary work involved with the application process for permit(s) from the Southold Town
Board of Trustees for this property.
v
Property Owner's Signature Property Owner' Signature
SWORN TO BEFORE ME THIS u A-3(L- _DAY OFc�-es �, 20—'-" _
L KAMAL P-30NI
Notary Public,State of New York
Notary Public No.01S06089949
Qualified in Kings county
Commission Expires March 31,2027
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics.arohibits conflicts of interest on the part of town officers and employees.The numose of
this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME: A i_ t Kumar& Jennifer Ecdestone
(Last name,first name,ipiddle 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.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance Building
Variance Trustee
Change of Zone Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning
Other
(If"Other'',name the activity.)
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 F-1 NO
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check
the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply):
_nA)the owner of greater than 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 23 day of 20
Signature
Print Name T 17
Form TS 1
APPLICANUAGENUREPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of gthics-prohibits conflicts of interest on the.part of town:officers and employees.The Rut•dose of
this form is.to provide inform n of information which can alert,ihe tow possible:conflicts of iiterest and allow it to take whatever-actiori is
necessary-to avoid same.
YOUR NAME: Portillo,Anthony
(Last name,first name,gniddle 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.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance Building
Variance Trustee X
Change of Zone Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning _
Other
(if"Other",name the activity.)
Do you persooally.(or through your'company,spouse,sibling,parent,,or child)have,a relationship.with 0y,'oflicer;or employee
of the Towkof�S.outhold? "Relationship"includes,byblood,'rrlarr4e;.or6usi6ess'intergst.,"Business-interest"•means-a business;
including a partnership,in which the townotficer or.cniployee h%as:even a:partial ownerstiip of(oremploymerit by.)a.corporatiod,
in which the town oflicer,or employee'owns;More.than 5%of the shares.
YES NO X,
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person-
Describe'the:relationshig between yourself(the applicanVag Vrepresentative)and the town officer or employee.Either check
the appropriate.line A)through D)andlor•describr<in'ihe•s-ace 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,than 5614.of the:shares ofthe corporate stock of the applicant
(when the applicant is a_corporation);
B)the legal or beneficial owner,of any interest in a,n_on-corporate entity(when the
applicant is rota corporation);
G).ax�officer,director,partner,or employee-of the applicant;or
D)the actual applicant.
DESCRIPTION OF RELATIONSHIP
' y ���ln ''
Submit day of ted this � 20?!vlJJ
Signature_ /
,. Print Name
Form TS l
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THE WATER SUPPLY, WELLS, DR YWEL L S AND CESSPOOL
L OCA TIONS SHOWN ARE FROM FIELD OBSER VA TIONS
FEMA MAP#36103CO167H EFFECTIVE 09/25/2009 AND OR DATA OBTAINED FROM OTHERS.
AREA: 20,412.31 SQ. FT. or 0. 47 ACRES ELEVATION DATUM: NAVD8B
-------------------------
UNAUTHOR/ZED AL TERA TION OR ADDITION TO THIS SURVEY IS A VIOLA TION OF SECTION 7209 OF THE NEW YORK STA TE EDUCA TION LA W. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY /S PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS
AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
SURVEY OF: DESCRIBED PROPERTY CERTIFIED TO: AJIT KUMAR;
MAP OF:
FILED:
SITUATED AT: BAYVIEW
TOWN OF: SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC
SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design
P.O. Box 153 Aquebogue, New York 11931
FILE # 222-57 SCALE: 1 "-20' DATE: MAY 10, 2022 N. Y.S. LISC. NO. 050882 PHONE (631)298-1588 FAX (631) 298-1588
