HomeMy WebLinkAboutSterling Brent Real Estate LTD SUFFotx
Glenn Goldsmith,President % Town Hall Annex
A.Nicholas Krupski,Vice President ¢jam y<'* 54375 Route 25
Eric Sepenoski ti ?� P.O. Box 1179
Liz Gillooly �4,0i ,Y Southold,NY 11971
Elizabeth Peeples 1 Telephone(631)765-1892
Fax(631)765-6641
Southold Town Board of Trustees
Field Inspection Report
Date/Time: 1 Z Completed in field by: • 6PI' 0
John Woudsma on behalf of STERLING BRENT REAL ESTATE LTD requests a Pre-
Application Site Visit to construct a pergola. Located: 3345 Bayshore Road, Greenport.
SCTM# 1000-53-6-9
Type rea to be impacted:
Saltwater Wetland Freshwater Wetland Sound LABay
Part of Town Code proposed work falls under: apt. 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.: �YCL c4 v
CArol �- r-,s go( V"7
Present Were: �' G. Goyrsmith ZN. Krup E. Sepenoski
Gillooly ✓E. Peeples
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UNAUTHORIZED ALTERATION OR ADDITION
0� N TO THIS SURVEY IS A VIOLATION OF
OagO SECTION N LA OF THE NEW YORK STATE Nathan Taft Corwin III
s e• p g\J p EDUCATIONLAW.
COPIES OF THIS SURVEY MAP NOT BEARING
f ' V JJ7 THE MBOAL OR
SS D SEAL SHALL D SURVEYOR'SINOTDBEECONS DERED Land Surveyor
o, TO BE A VALID TRUE COPY.
CERTIFICATIONS INDICATED HEREON SHALL RUN
SEP ZQ24 ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO THE
TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys — Subdivisions — Site Plans — Construction Layout
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTI—
TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. PHONE (631)727-2090 Fox (631)727-1727
ISLAND VIEW LANE OFFICES LOCATED AT MAILING ADDRESS
Board Df Tnistees
THE EXISTENCE OF RIGHTS OF WAY 1586 Main Road P.O. Box 16
AND/OR EASEMENTS OF RECORD, IF Jamesport, New York 11947 Jamesport, New York 11947
ANY, NOT SHOWN ARE NOT GUARANTEED.
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Note: In order for Walpole Outdoors LLC to begin construction on this job,all drawings must be approved and signed by the CUSTOMER and/or ARCHITECT 1 CONTRACTOR.
Customer signature/Date Product: SKU#SQUARE Columns: Date Drawn: 113/2017
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Note: In order for Walpole Outdoors LLC to begin construction on this job,all drawings must be approved and signed by the CUSTOMER and/or ARCHITECT if CONTRACTOR.
Customer Signature i Date: Product: SKU#SQUARE Columns: Date Drawn: 1/3/2017
�V�alpole Outdoors_ 1 Ox 14 Free Standing Flat Top Pergola 795387S Drawn By: SDD 1 . 20 c
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795387R Mgr.Approval:
To: Town of Southold
Board of Trustees
Dear Board members,
I am representing Brent Nemetz, president of Sterling Brent Real Estate LTD, owner of 3345 Bayshore
road (sctm: 1000-53-06-09) in Town of Southold for an application to construct a Pergola on his property.
We are requesting a pre-application site visit to discuss the project. Included with this letter is a survey
depicting the desired location of the pergola, plans for the pergola, an affidavit giving permission for the
trustees to enter the property, and an authorization form allowing me to represent Mr. Nemetz. '
I can be contacted at (631)374-3920 or builder@johnwoudsma.com. I am Looking forward to meeting
you soon.
Than ou,
Jo Woudsma D
� f-1! E �h
gent for Brent Nemetz
(631)374-3920 SEP 3 2024
OW Town
ird of Trustees Applicati(
AFFIDAVIT
B,�lerr/ Ny1 r�, &ep Dw or ST BEING SWORN ?D.
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
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 VITH 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.
Mes"PVN�/
Signature of Property Owner Signature of Property Owner
SWORN TO BEFORE ME THIS 2 °��DAY OF 20
otary Public ^:T. ' .. .. . .. .......:...'
AHULD E..NkW,FZ '
Notary Pubme.$we d mewye*
No.U-014.1.*-,&"aD�ty
I' rd of Trustees Applicatic
AUTHORIZATION
(Where the applicant is not the owner)
I/We, A/PNI877- PAV51'D67V I or 51EY-MA411901 f2 1'Z,ES7 t 71).
owners of the property identified as SCTM# 1000- -r 3 0 h — O in the town of
Sou/ 44—( /D New York,hereby authorizes
-:Sd V y o VD to act as my agent and handle all
necessary work involved with the application process for permits)from the Southold Town
Board of Trustees for this,property.
494
Property Owner's Signature Property Owner's Signature
SWORN TO BEFORE ME THIS_ 2- � DAY OF AVrV-j 7 , 20
t9ly
Public •• jp�p E
Not"Pu61ic.ft"d*mw vmk
No.52-48144M=3mM*CowAy •
Tit Exptret Tor
A.PPLICANTIAGENT/RE-PRESENTATIVE
TRANSACTIONAL IDISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on ilte part of town ofl9cers and employees.I'he purpose of
this form is to provide information which can alert the town of pqLsiblc conflicts of interest and allow it to take whatever action is
necessary to avoid same. � /� �^
YOUR NA AE- l.y I�Ll n)C I�^J 1`� r 1\� �S T�'1T L L T l�,
(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 Mood
Exemption from plat or official map planning
Other yr...�( _ S
(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,artarriage,or busnress interest_"Business interest"-means a business,
including a partnershi),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 Haan 5%of the shares.
YES NO
ifyou answered"YES",complete the balance of dais 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/agi;ut/reptesentative)and the town officer or employee.Either check
the appropriate litre 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 than 5%of the shares of the corporate stock of the applirshat
(when the applicant is a corporation);
B)the legal orbeneficial owner of any interest in a non-corporate entity(whdn the
applicant is not a corporration);
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant.
DESCRIPTION OF RELATIONSHIP
AC-)
Submitted th' d f 200?�
Signat
Print N
Form TS I f