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HomeMy WebLinkAboutPlimpton Family, LLC SAMUELS+ S,TE E LMAN lifilt�S3f)3ilL-71Sc3#3L�StL'L'1#138f3.�t3f33 E C 631-734-6405 Samuelsandsteelman.com FEB 21 2024 2/2/24 Southold Town Board of Trustees Board of Trustees RE: Plimpton Residence Town Hall Annex 12250 New Suffolk Ave Cutchogue, NY 11935 PO Box 1179 SCTM#1000-116-6-11 Southold, NY 11971 Dear Permit Administrators, We hereby request a Letter of Non-Jurisdiction for the above reference project. All building are outside of the jurisdiction, and any construction work proposed is also outside of the jurisdiction. We have provided more historical photos documenting that the bulkhead existing was built prior to 1978. For your review we are submitting the following documents: 1. Two{2)stamped SITE PLANS 2. Historical Photos 3. Photos of current bulkhead Please get back to me with any questions, or if we can provide additional information. If this application is compiete and when it is approved, please send me a Letter of Non jurisdiction. ��cer�iy, KATE SAMUELS SAMUELS & STEELMAN ARCHITECTS P.LLC North Fork 25235 Main Road. Cutchogue, NY 11935 New York 115 Broadway Flr 5 New York, NY 10006 ' .� '.2� 3c-: •yW, �._ � c -�X-ae � 3 'eft 4 3 fi M `4i Y s ... 2250 N !w iuffolk Bulkhecl i Olt MPA 4 s_ tidal W( Hands v Oap 71 ( -540 1974. =� 12250 NE ,r y Suffolk 2 iulkhead v.. Tidal We hands Map 710 1540 1 1974 I E / K t L Or s �. f r Wiz,. r TVIS y, 1 W r F E B 2 1 2024 7 i Southold Town Poard of Trustees 12 50 NEW SUF OLK AVE, CU CHOGUE, N) 11935 PHOTO LC JKING SOUT FEB 2 mthold Town rd of Trustees A r � -._':t ry •� t � o 4 r-+ `: Yt E' �' '�tf �,. >1;�. r � -R, CIF� .,.� :.i�s4� .�J n „ '����r '��• t_ � , r , X�i� r f�r*�� � t STY,.. � 1�,��t i �- •. ,`,y� �- { .ae I�i.�p�w��w j' s"3 � A�fir, ' tQ S �,-•� �_�. t M � 'r.. r • n ` 12 50 NEW SUF OLK AVE, CU CHOGUE, M L1935 PHOTO U )KING NORT ARCHITEC 3: BASED ON SURVEY BY: JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET L I S+ RIVERHEAD, N.Y. 11901 M A 631-369-8288 jesurvey@optonlire.n 'I Z03"T L Ar4 N.Y.S. LIC. NO. 50202 CERTIFIED TO: E BIG APPLE ABSTRACT Corp. ' ---- 25235 MAIN ROAD TITLE No. BAM 18488 F E B 2 1 2024 TCHOGUE NY 11935 631.734.6405 OLD REPUBLIC NATIONAL TITLE iNSURANCL I;Ok.`PA!"lY CONSULT, 'TS: STEVEN LEDERMAN NOTES: 1 . ELEVATIONS ARE REFERENCED -i-U N.A.V.D. 1 ,.6 DA U`vl EXISTING ELEVATIONS r�4;:- IC)V'!'•. 1 f 1! I , EXISTING CONTOUR LIN'IE.O- API A. xx F.f 1. FIRST FLOOR G.FL. - GARAGE FLOOR T3 TOP OF BULKHEAD BB BOTTOM OF BULKHEAD TW TOP OF WALL BW BOTTOM OF WAI_I_ 2. THIS PROPERTY IS IN FLOOD L(-.;NL- X i FLOOD INSURANCE RATE IVAI No 13-610")'005� : } i OWNER: ZONE AE: BASE FLOOD ELEVf''.i LOINS DL_ i I NICOLA Pi ZONE VE: COASTAL FLOOD �-JITH V1=LOCI i y H'..":Ai�i (. ' ,,JAVE AC i-ION) N/O/F 12250NEV V UFFOLK AVE 4PTON AND RUSSELL MCCALL BASE FLOOD El L'�t,A,`• IO11S PIE E ;hN ? 250 > AVELNO LLC � i NEW SUFf LK, NY 11957 ZONE X : AREAS OF 0.2% ANf' 13,f,` v': 1`'., ANNUAL CHANCE FLOOD WITH AVERAGE CIEP"H OF ;,Fc ' I ` .`'l,' " F'-'OT OIL 1''.!ITH DRAINAGE AREAS LESS THAN I i 1 SQUARE MIL E. AND AREA , PRE' CIC T,'D [::7' LEVEES FROM 1% ANNUAL CHANCE FLOOD. m REVISION ZONE X: AREAS DETERMINE[:) TO cIE OU'i`SIDE, IFHF. 12`s:'. ANNUAI CHANCE FLOODPLAIN. ' 0 O D O v D ° I m m = m D � 1 N 12°3 30 E T WOOD POST WIRE FENCE w 412.47 < m D m < rn D m o m WOOD POST&WIRE FENCE \ o m m O = m o m 2nZ Nz aI M n � _ z n mo T� m C7 m m n D WOOD POST&WIRE FENCE m WOOD POST&WIRE FENCE I; WOOD POST&WIRE F CE ROW OF CONC.POSTS ALONG PROPERTY LINE 1� 1'cn o w OST O I I O _a WOOD 'J °-' ! m STAIRS 10 61.0ST D r &CO0-) N F S� m o EW WATER LI . .. o Rv . M p I i I N ,w C NC CURB X / Ism . . o N 1A 0 ONpO ,o °D X r -+ \ O CLEAN I 9�� I Q t 1a _ ....�... .vOVT \ _ _ �$ Wth REMOVE WOOD D CK 6" CIO 1' —M�� 0'r m D D s I ABOVE RADE _�-M EyECTRIC 16�0 I AND DRY-STD CNGD pw nGP� GRAVEL DRIVEWAY M —M METER OO��yd� 9 ONpO STONE E I, 1-- y \1. STONE&CONC. 8X4 WOOD -� O� \� PILLAR D \ ON U M JCX DW � �M C.C Rg STEP WALK STEPS NEW WOOD K6" l\ 8X4 a ABOVE RADE 1 \ ^� \ i �j D I y I WITH STEPS TO GRADE 1� V / EW WAT R LINE (/n 1N ,�OjP�O OVFRy M D W ( '/ II - ----- �OUTHOLD I EMOVE RAVEL U >d� /FD� TRUSTEES 100,-0" E COVERED " J -m-ID - - _ I m WALK AN CONC.STEPS W CO D -� t. 1KOS= ^' AND CUR WOOD DECK AND STEPS 1'r M m m 169'4Q HWM I X E VE BRICK / ° D - -- 1 / OW WELL EMOVE EXISTING )C Cr l m I I DECK CELLAR ENTRANCE } m / _ _..._._� 112.5'TO WALL 1N ) Z I D EW BLUESTONE z c i z REAR YARD I I I OIL ILL CAP STEPPING STONES 00 00y Imo C ° . D ° J W G� 50'-0" B I K WI OW (2Xa') y 7 -- R I u x . ----..__ -_- ---.-- I I L P. OG Q� �y �,�yd \/ ETIREDCESSPO I O D ' C7 ,i j m .�-� � A CAS IRON P � �i ./ � ° . � ' NYS DEC 75'-O" I XISTING CESSPOOL 10 0�00 M 0 o J V - � ❑ TO BE RETIRED 7 < - C ° D D EXI TINS BRICK ` _ °I ' WI DO�J WELL - o M1� M WATER M m 1 I D Bias U " LINE M--- 10 m I PROPANE M M M O d D ! I. NK G� m ° to 3 m U 0 D R I ( I OVERED M n 8X4 ^fir \ m D U " I PORCH m o S1 d� 1 / \ OD TIE 1w O D CANTER 1 L7 REMOV SANITARY SYSTEM vOi � OaC H�F ,rn X 1 4'DEEP LEA CHIN �' ,. PROJECT )DRESS: _ I i SCREENE[kN TOey� 1 ` GALLEYS W < \ PORCH Irn - CONC. �66 \ - c _ _ _ _ _ _ _ 12250 NEV ;UFFOLK AVE STEPS— � to 1m— � W ° ' W (fl01 _) I D —` D NEW SUFf LK, NY 11957 Q7 " V. 1� m EW GENERATOR O -J I �W L o m I I �ax� n� �`° N x N x ON REc�sT-S= Q v, m FR NT YARD SET BA K --]" rn z o 15.0' r r n - STOCKADE ENCE CONC. FENCE 0 O O D 50 0 FENCE w " s n I 8_6 rna'JoA�-=F.Fl. PLAT. 0.5 VV. T. FENCE 0.8'W. FENCE 0.7' 1 7 W 15.0' 1.6'W. ,N OCKADE FENCE 10 1.81S.0.2 W. STOCKADE FENCE p D j' 1� EW AC 1� IFT STATION rn ( D ARC'y n FENCE CONDENSER �- OVERHEAD WIRES REMOVE THE $ �� XISTING CESSPOOL v z c O n D J EA f TO BE REMOVED Z NS9���� o I 0.4'E. METAL POST&WIRE FENCE o T EW DRYWELL TO = r D i m z O m z CONNECT TO G c. n m ° m HOUSE DRAINAGE mp n UTILITY T TALL RETAINING WALL O� D .ODD EMOVE n POLE m Z i m O D m OUTDOOR r7 m S 12`, ?/ O AND FENCE ' m 426.11 s I I I gD D P 04436 �O i N/O/F I FOF NEW TODD FREED S.C. T��`'.X �'JG. j>: ? ~'`'• & EDITH WEBSTER FREED — i SCk-i- i 0 DRAWN 8 KS f�,�;E;� -� ='5,"i�'`a �`� `�• SITE PLAN I DATE: 10.9.23 >,I SCALE: AS NOTED SCALE: 1 / 16" = 1'--O" DRAWING HEET NAME: I SITE PLAN DRAWING HEET NO: ARCHITEC -S: BASED ON SURVEY BY: JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET SA MUELS+ RIVERHEAD, N.Y. 11901 631-369-8288 jesurveyQa opton line.net N.Y.S. LIC. NO. 50202 ST �I.ELMAN CERTIFIED TO: 25235 MAIN ROAD BIG APPLE ABSTRACT Corp. UTCHOGUE NY 11935 TITLE No. BAM 18488 c 631.734.6405 OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY - STEVEN LEDERMAN FEB 2 1 2024 CONSULT, '�JTS: NOTES: 1. ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM EXISTING ELEVATIONS ARE SHOWN THUS: xx.x EXISTING CONTOUR LINES ARE SHOWN THUS: xx xx F.FL. FIRST FLOOR G.FL. - GARAGE FLOOR TB - TOP OF BULKHEAD BB - BOTTOM OF BULKHEAD TW - TOP OF WALL BW - BOTTOM OF WALL 2. THIS PROPERTY IS IN FLOOD ZONE X AS SHOWN ON I FLOOD INSURANCE RATE MAP No. 36103CO501 H OWNER: ZONE AE: BASE FLOOD ELEVATIONS DETERMINED N/COLA Pt MPTON AND RUSSELL MCCALL ZONE VE: COASTAL FLOOD WITH VELOCITY HAZARD (WAVE ACTION) N/O/F 12250 NEV! "UFFOLK AVE BASE FLOOD ELEVATIONS DETERMINED AVELNO LLC ' NEW SUFf JLK, NY 11957 ZONE X :*AREAS OF 0.2% ANNUAL CHANCE FLOOD; AREAS OF 1 IN, ANNUAL CHANCE FLOOD WITH AVERAGE DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN ' 1 SQUARE MILE; AND AREAS PROTECTED BY LEVEES FROM 1% ANNUAL CHANCE FLOOD. REVISION, ZONE X: AREAS DETERMINED TO BE OUTSIDE THE 0.2% ANNUAL CHANCE FLOODPLAIN. O ° O< D 1 m m ° 3 m 0 1 11 WOOD POST&WIRE FENCE 412.47 -o � � D N 12 35 30 E w I n a n T WOOD POST&WIRE FENCE T m �7 'n (n t o� CD m _ _ _ m om �0 L',z NZ i.m mC-) n wn ° Z �n m M �� m m n m D. WOOD POST&WIRE FENCE r" WOOD POST&WIRE FENCE ° ° ° t'� WOOD POST&WIRE F CE 1Nf 1t�.� CO ROW OF CONC.POSTS ALONG PROPERTY LINE 1� 1�, OST °'. 00 W A 0 ,W ,-` O G1O , OO -" 0 N •moo, 0.6'S. D ° m WOOD to �\ �o m 1 01 STAIRS IW 61.0 ° C I O -� �► SAZPATH t I _ D to M n�. ° o t ST W �, � &C N , \ t m C , `c \ m EW WATER LI 0 - � �p 1 �°o 0 C) CONC.CURB X Im m ro 1a ONOO 1`I Q ° 0 8 CLEAN K I I 1~ 00 10 _ o to OUT \ � - ry% I w - N.A O o \ I n y o � I Illui > REMOVE WOOD DrCK 6" 02 1'11 y-1�— _._.. ,_ T.{ \ Oy D T. ° of '7c '`°,' I I ABOVE 4RADE -fA E�ECTRIC �0 v AND DRY-ST CKED OG GRAVEL DRIVEWAY M—��M M TER O.�'�j�d13` ON0'J 1> rn (4) O STONE EDrINGS 8X4 �� ` M�- C WOOD v p�i �\ d0 9a,` STONE&CONC. b - ' n a \ M ONC C(7 STEP Iw WOOD ,cn M PILLAR ® I DW 1 RB CONC. p S, I I NEW WOOD JCK 6" 1X 8X4 �S WALK STEPS ,y� zi o I cn U ABOVE RADE 1• „\ 1N �J \ `/ I ° L J ro w D I X WITH STEPS TO RADE `o EW WAT R LINE I v I irTO WQ ° 1 BeUR/FD)) D ° I 1� 7 SANG PATH I - --_. SOUTHOLD TRUSTEES 100-0 I I ,N WALK ANAN CONC.STEPS 1� EW COVERED �' U \ m-Di AND CUR WOOD DECK AND STEPS m z 17D'4 HWM I X E VE BRICK 165'-4 EMOVE EXISTING X -- OW WELL ° C rn DECK CELLA(2 ENTRANCE �' � p'• Im / 112.5 TO WALL 1N v \ \/ Z Z '- REAR YARD EW BLUESTONE �r goy / :° r � O 1 OIL ILL CAP STEPPING STONES 4Ld q D _ 50'-0" B I K WI OW C'p,LO , _= =��y p' ° to L O }7; ' o�y yd ✓ ETIRED CESSPO .�In O CAS IRON P � �. '�� is \ °'• XISTING CESSPOOL (� z NYS DEC 75'-0" ❑ o ' . ...� � ', TO BE RETIRED �O / � I-- , I t ' 11 m ° C t = 1s cVr, EXI TINq BRICK = 0 1� �� M / 1 1 a D °L V WI DOt{J WELL M1'4 M _�M � M -M---_ ° -nt w I I ° WATER LINE M— o , A � � 1 1 PROPANE O M M M M M 1 D 10 m m DW \ �J T I x o y I I I OVERED m n 8X4 �� PORCH A 1 \ ' OD TIE I I'w O ° \/ Ito o / (� LANTER n I o REM OV 7 \ 1) SANITARY SYSTEM to i X V - ou ?+ x / \ y PROJECT :DDRESS: 0� O!� 1 4'DEEP LEACHIN ° ..� \ °f SCREENE(�^w �T0 4y� 1°i 1 ` GALLEYS (A rn y PORCH rn�' CONC. eF6 \ / 0 1t, w IV m ; — — _ — — � STEPS_ _ G��iR� — 1 — — — — — — — — L o (� 12250 NEV! SUFFOLK AVE c NEW SUFf ?LK, NY 11957 I i r to I j o I I ATOR 6 0 ,`° ,� Ix N x oEN RE NERc�srstxs a �_, a FR NT YARD SET BA K ° �_ T o cc m z v 15.0' CONC, FENCE d 501-On I ° rn ' ' oNo q PLAT. O D FENCE STOCKADE FENCE STOCKADE EN F.FL.8_6 0.5 W.� m ° D FENCE 0.8 W. FENCE 0.7' 1 7� 15.0 1.6'W. 1N OCKADE FENCE ko 1.B'S.0.2'W. _ FENCE 1� EWV AC 1� IFT STATION �D ARC I onto 0.4'E. METAL POST&WIRE FENCE o n EW DRYWELL TO CONDENSER OVERHEAD WIRES REMOVE THE $ XISTING CESSPOOL v z c o ENE JEA/�S 6, P m z z `O m Z \ CONNECT TO a: C TO BE REMOVED Z r-'- D �� c� m -� > HOUSE DRAINAGE T TALL RETAINING WALL E m r- m m p 0 UTILITY O' N G i- v OUTDOOR OVE n POLE O m ° c' S 12°31 '10" W SHOWER 426.11m 1 AND FENCE D: ° gt> ' t ;1T 04436 OQ`� I N/O/F EOF NTODEw� S.C. TAX No. 1000-116-06-11 WEB FREED — I & EDITH WEBSTER FREED SCALE 1"=20' OCTOBER 3, 2022 DRAWN B' KS AREDATE: 10.9.23 SITE PLAN A = 55,356 sq. t. I SCALE: AS NOTED 1 .271 ac. SCALE: 1 / 16" = 1`--O" i DRAWING SHEET NAME: I SITE PLAN DRAWING SHEET NO: SURVEY Or PROPERTY SITUATE CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-116-06-11 rA i t'-2-0- AREA=55,358 sq.IL I.Z7t ac t-ELMUM&APE PFEEP.EL#/.Flm TO,ml.A,a.[m,AM VAUM EYISHHO'ELEVATIONS ARE SHOWN THUS AM .. EMSDNG CMMUt EWES ARE SHOW4.fHUs:..xx-----af' _ FJt-fuRT HOQY �-'�..._�.:�• ...._.:. �_ ��� ro -maw aFwaHa O 2.THIS m -trvar rx>_ g-• r :`"`'•V.•�..'. - !F'' -Wady tK.. PROPErmTY ISS IN IN FLOOD ZONE IT AS SHOWN ON FLOOD INSURANCE RATE HAP No.3fitO3COSOt H - -��•.. '.as v J-+.�T U� MNE AE; BASE FLOW ELEVATIONS GEMMED ZONE tE: COASTAL FLOOD WITH NnCa Y HAZARD(WAVE ACTION): . .x,l.+x Sa z::._' }._ '• •.+' -.. BASE FLOOD ELEVATIONS DEtSUMED ('0 Z0.QC%': -mAs.o .C3. ANNUAL CILNCC I-LOM Eu r I5RaNNUAL-CIONCE RMD Ana su'-Lx—ss:]H :a:;=- :Yr"7T u��7'dflE AlE+5:ic55:TFiaS 7 SPd1mRt ME-AM ARDS FEM7EE7E4 8'f)R1MFG FPI.dd 1z A7D9diL C}NtEE I-2� 2OPEx Ig3EMMED-MWrWMW MIT asr_r.PZMDItsaY1TEnOOEFIAa. Aar : l t r —tt ) Qua >u p&Ft 4 { t 5 s'• •.t r • _ Q _�- = .+U ..:.-._.��- :�.•� 4 Ara_J 4. W��y a_• �. - ^"--_ -. - _ - __.—_- - y 1� stNr g¢, nct f, s+ Dt a 11 r 11 ,A ?wwt M1w Z--�-�, rz (q l_ �} i u _/�, ` ._ _ -- _, 3 lA 'W• DEC 2 6 Zo3 a Board of Tr stces .>a Vic- 732 9 munawa icxvramru- �>m�a ns o or mes @Bft�]` f6 PCfR��M71iB t9 Pf6�.�M W�WF W TIg IFmtm mtll�lan �4 MO ' NOE�fF56aE�tS�F mm®B !vf ml(HpY9G Td fl�[Wi 6 NdR!K rAts FIUNa F�f15 OI'I✓lmlp.P Illf,MAT 9�t911/IR Ip]WMMIIQ6 �m �T iq a a� a R Land Surveyor Swrefv Ta 9eQa A,�u13 +l lAA T!Y Ss�-^�665hima-9e A9aot-C�Lotltm kp0 MIKE(IBIVV-2= to(Bil)7lA-1TD l�p !aP➢l.AOa ts, yph F B.1V oe�uL Ja Nn Yh r 119R JameIDvt�YarY 1/97 MM LY.Na 5a187 E-YFL W..vDOm/.mo Glenn Goldsmith,President 'of S®(/f� Town Hall Annex A. Nicholas Krupski,Vice President ,`O`� ®�® 54375 Route 25 P.O.Box 1179 Eric Sepenoski l Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples � a® Fax(631) 765-6641 �®UI111�,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD NON-JURISDICTION INSPECTION - At 7 Z DATE OF INSPECTION: Y Ali. INSPECTED BY: �(�'� zl ka/a-3 J-0 /Ch. 275 Ch. 111 GA7U COMMENTS: Late �6 OD foe IJ e art-t SAMUELS+ S EEL AN D EC katen3i satyiuelsand8teelman.con) JAN 12 2024 631-TI 4-(340 5 Southold Town Board of Trustees Board of Trustees RE. PTimjD1on"Ree-dejvae 1225?-NO-W-Stt-11-folk-Ave TOx,mcn.Hall Annex Cutchogue,.NY 11935 PQ-130.x 1,179- SCTM,#.TOGO—UG-494,1 Southold,NY 11971 Dear,R?r I SI L Admi1 dgtm,'= We hereby f-equest � Letter D3 NQ-t-Jurisdiction for the sal ve reference pr6ject. All Wilding are outside df'thejutisdiction,:and apy construction work proposed is also outside of the jufisdicfion.-For your review we are submitting.the following documents: SURVEY 3. Owner/Agent Authorization Letter 4. Affidavit 5. Thrr---- photos pm*ct site 61 - —check'Ifor:$510-101 0 Please got back to me with any questions,or if we can provide additional information. if this application is complete and when it is approved, please send me ar Letter of Non-jurisdiction- Sincerely, SAWILIEL-S& STEELMAN ARCHITECTS PLLC Kate Samuels_ North Fork 25235 Main Road culchogqe'.Ny 119.35. New.York 115 Broadway Fir 5 New York;NY 10006 DiSalvo, Diane From: DiSalvo, Diane Sent: Tuesday, December 26, 2023 1:47 PM To: 'kate@samuelsandsteelman.com' Subject: NJ Request 12250 New Suffolk Avenue - SCTM#: 1000-116-6-11 Attachments: 20231226134333.pdf I With respect to your recent request for a Non Jurisdiction letter for the above: See attached forms which must be signed by a Member of the Plimpton Family LLC, as owner of the property. We will also need to see proof that whomever signs on behalf of the LLC is an authorized Member. There is a$50.00 fee for issuance of the Letter. Please send us a check made payable to "Town of Southold" in the amount of$50.00. Please also be specific as to what structures you believe to be out of our jurisdiction. Thank You p�avLe pisaLvo o f fbce AssIStGlvLt southoLd TowvL Trustees P.D. gox 227 9 southoLd, NY 22972 (632) 7ro5--1892 1 SAMUE-L-8+ STEELMAN -� E f:. _f DEC Z 6 kate.(as.aa.)Lielsandsteelman.c0rn f 631734-6405 E Samuelsandsteelman.com 1f 5outticldTown -Board of Trustees 12/21./23 Board of Trustees Re: ADDITION AND RENOVATIONS TO THE PLIMPTON Town Hall Annex Building RESIDENCE 12250 New Suffolk Ave, Cutchogue, NY 11935 54375 Route 25 PO Box 1179 Southold, N'r i 1971 Dear Staff and Board of-Trustees, I hereby request a Letter of Non-Jurisdiction for the above referer-iced project. There-is an exirA4-ig b it-khead in place.that is prior to 1977. DEC Tile Wetland map #710-540 references the location which shows bulkhead prior to 1962. Please see attached documentation: 1. SURVEY 2. Historical photo project site Please get back to me with any questions, or if we can provide additional information. If this application is complete and when it is approved, please send me a Letter of Non jurisdiction. Thank vou, Kate Samuels North Fork 25235 Main Road Cutchogue, NY 11935 New York 115 Broadway Flr 5 Now Fork.;dY 10006 _r Nicola Plimpton Plimpton Family LLC 12250 New Suffolk Ave Cutchogue, NY 11935 We hereby authorize Kate Samuels of Samuels and Steelman Architects PLLC of 25235 Main Road, Cutchogue, NY, to apply for all required permits from the Town of Southold, Suffolk County and State of New York, for my project at 12250 New Suffolk Ave, Cutchogue, NY. Sincerely, l 1 Nicola Plimpton Date: / 2' MEMBERSHIP CERTIFICATE Of THE PLIMPTON FAMILY LLC A Limited Liability Company Formed under the Laws of the State of New York CERTIFICATE NUMBER: -1- This is to certify that NICOLA PLIMPTON is the sole member of the above limited liability company. Transfer of this certificate and the benefits and obligations of membership are as set forth in the Operating Agreement of the company, as same may be amended from time to time. WITNESS the signature of the Member of the company on the date set forth below: NICOLA PLIMPTON, 01mber Dated: Cutchogue, N.Y. February 14, 2022 Ile-membercert Board of Trustees _implication P1 AUTHORIZATION (Where the applicant is not the owner) o Gc, I/We, - - owners of the property identified as SCTM# 1000- � ^--1 _: in the town of ;.New York, hereby authorizes . .... .... KATH ERI N E SAMU ELS 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, Property Owner's Signa a Property Owner's Signature SWO O BEFORE ME THIS DAY OF LOGAN KIERA NIGHT Notary Public Notary Public Maine My Commission Expires April 19,2030 y Board of T,rustees%J -)placation d . AFFIDAVIT dico) , 911 M I BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERNIIT-(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),1F 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 Nvner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF.. Q-VlU _ 20 a `{ LOGAN KIERA NIGHT Notary Public Maine Notary Public My commission Expires April 19,2oso MATcH 1 I xc` sTowT+of wu,HOLD � �vEcow-NDTRUST"i01-11 � � 33A1c) � w.n.0 i � --}}� `�\ '„ '�i,�.�,� I � ��,•�y � (As�; :3 I v r • \ TOWRI OF 1 � �j',\ S� 1� '', � � "E_�'2 9.9A(1 �, wureDLD \'v a'�39A 1 'h' '' 31 m T A �?h, '\'rra '>k 9 A P WIN P� All is<A - ,f 9sAtc7 t \ 32n1! Nttc]ar.ax eLONGIANOTRUsi Y,t- ( ,,, *ems,,tom✓r ;•z7� to : I ��' -. 1 i rob,�9.•u DN,- . - _ - ' 1 zsa() •r'Y 9 �c 2 S 18AIc) t � } : uN� _ ryFN / 1 .9 r td 1 rovsv FO EQ)U]HOL➢,.....•.` _ T 1 ... {{ :. —:i g$ \\i �•At1 Ji , A q IL J 17 .! ] - - M, _ 1 %��, ,,,, 't .. 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