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HomeMy WebLinkAboutTR-6067Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southotd, New York 11971-0959 Telephone (631) 765-1892 Fax ~631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0087C Dme 1/5/06 At THIS CERTIFIES that the bulkhead & dormer and deck additions to dwelling 60 Fisherman's Beach Rd,, Cutchogue Suffolk County Tax Map # l 1 l-1-6 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 12/29/04pursuant to which Trustees Permit # 6067 Dated 1/19/05 Was issued, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the bulkhead and dormer & deck additions to the existing dwelling The certificate is issued to aforesaid property. ALAN & TERESA MONTANO SUCHER owner of the / Authorized Signature-- Albert J. Kxupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Sputhold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 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 Pre-construction, hay bale line 1 st day of construction ~ constructed Project complete, compliance inspection, Albert J. Krupski, PresidentI James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 S. outhold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 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 Pre-construction, hay bale line 1st day of construction ¼ constructed Project complete, compliance inspection. Board Of $outhold 'Tom Trustees SOUTHOLD, NEW YORK ALAN & TERESA MONTANO SUCHER Aut'harizatiau Pursuent to the prov'~ions of Chapter 615 of the L~w~ of t~. Ste~ of New Y~ 1893~ end ~pter ~ ef ~ ~ of ~e ' State ef New Yo~ 19S2~ end ~e ~d To~n ~ .'~~ .~D -~E .P~G. ~, ~U~S IN AND ON TO~ WA~RS AND PUBUC ~DS e~'.~ R~OVAL OF SAND, G~VEL' OR O~ER MA~IA~M ~DS .UNDER TOWN'WA~RS~. Re~io. of ~e ~rd adopted ef · meeting ~ ~ ...4.a~,..~..k~. .... .zg~....~ and ~ ~er,tlon of the sum d $.....2.~.~.~Q.Q..... ~id by Alan & Teresa Montano Sucher of .......... ~.~.~?.~.~ .......................... ~ .................... N, Y. ~,d. ,ubj~ ~ '~e T~ end ~d~ fid~ o. ~e ~v~ d~ ~, ~ ~f~ To~ T~s a~horkes and ~ ~ f~g: IN W~S ~, by causes Ifs Corporate Seal 1o be affixed, and these presoflh fo I~ subsed'oed by ~'mejod~/of the said Board as of ~hh d~d~. ~Send ~ Alan & Tere,sa Montano Sucher ~ 60 Fisherma~s Beach Rd., Cutc~o~ue Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 January 19,2005 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Robert E. Herrmann En-Consultants, Inc. 1319 North Sea Rd. Southampton, NY 11968 RE: 60 FISHERMANS BEACH RD., CUTCHOGUE SCTM#111-1-6 Dear Mr. Herrmann: The Board of Town Trustees took the following action during its regular meeting held on Wed., January 19, 2005 regarding the above matter: WHEREAS, En-Consultants, Inc. on behalf of ALAN & TERESA MONTANO SUCHER applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated December 29, 2004 and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on January 19, 2005, 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 97 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 the Board of Trustees approve the application of ALAN & TERESA MONTANO SUCHER to remove and replace (in-place) approx. 168 linear ft. of existing timber bulkhead with vinyl bulkhead and backfill with approx. 75 cy. clean sand fill to be trucked in from an upland source; remove and replace (inkind/inplace) existing step- down platform (as necessary) during construction of bulkhead; construct dormer, deck, and chimney additions to an existing 1.5 story, one-family dwelling, and all with the condition of a 10' non-turf buffer landward of the bulkhead, and as depicted on the plan prepared by En-Consultants, Inc. last dated January 21, 2005. 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: $50.00 Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/Ims EN-CONSULTANTS, INC. 1319 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 www. enconsultants.com ENVIRONMENTAL SERVICES Albert Krupski, Chairman Board of Trustees Town of Southold P.O. Box l 179 Southold, NY 11971 Re: Alan and Teresa Montano Sucher JAN 2 5 2005 Southold Town B0~rd of Trustee~ 21,2005 Dear Mr. Krupski: As discussed during this past Wednesday's public hearing, please find enclosed (3) copies of a project plan modified to depict a 10-foot non-turf area to be maintained up to 10 feet landward of the new bulkhead and a notation that any intertidal marsh vegetation disturbed or lost during the bulkhead constxuction will be revegetated with Spartina alterniflora (I 2" o.c.) upon project completion. Should you require any additional information before a permit can be issued, please let me know. Re, yours, - Robert E. Herrmann Coastal Management Specialist Enclosures EX[ WOOD PLATFDRM AND STEP~ TO DE REMOVED AND REPLACED (IK/IP) VIA' II LITTLE HOG NECK = 40' NASSAU POINT AI~^ OP P1511.1~,~h.L-Z/ I- If' . I (~) 6" ×6" W,~.t~5 X ~)" X 16' III - I0' C.-LOC VIN'?L F:eI~AJHIN~ O' PlblN~ EX, WOOD PLATFORM AND STEPS TO BE REMOVED AND REPLACED (IK/IP) = 40' 1, NASSAU POINT X fi,, X I~' C-LOC VINYL 5t~ATHIN6 )' RLIN~5 PP, OPOCP BLLKH~AD F~MOVAL AND ~FLAC~Mt~NIT' (IF) POP. ALAN ANP MONfANO 5LEH~I( OKI HAYVv'AI'CP~S COVe, CLiTCHOdL~, 51JPPOLK COUNTY, NY .q'IPZTI OPI 12/7/04, 1/21/05 1' = 40' 1, EX, ~DDD PLATFORM AND STEPS TO BE R£MOVED AND REPLACED (IK/IP) LITTLE HOG NECK NASSAU POINT ~C?ION ~ PUbKHI~ I~?bACBMBNI' Telephone (631) 765-1892 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York I.I~71-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD TO: Southold Town Board of Trustees FROM: Southold Town Conservation Advisory Council DATE: January 11, 2005 RE: Recommendations A meeting of the Southold Town Conservation Advisory Council was held Tues., January 11,2005. The following recommendations were made: DISCUSSION AND RECOMMENDATION OF WETLAND PERMIT & COASTAL EROSION PERMIT APPLICATIONS Moved by Don Wilder, seconded by Nicholas Dickerson, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A CONDITION of the Wetland Permit application of ALAN & TERESA MONTANO SUCHER to remove and replace (in-place) approx. 168 linear ft. of existing timber bulkhead with vinyl bulkhead and backfill with approx. 75 cy. clean sand fill to be trucked in from an upland source. Remove and replace (inkind/inplace) existing step- down platform (as necessary) during construction of bulkhead. Construct dormer, deck, and chimney additions to an existing 1.5 story, one-family dwelling. Located: 60 Fisherman's Beach Rd., Cutchogue. SCTM#111-1-6 The CAC recommends Approval of the application with the Condition of a 15' non-turf buffer in order to prevent chemicals from entering into the water. Vote of Council: Ayes: All Motion Carried Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fex (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application ,~Ve~land Permit Application ~' Major Waiver/Amendment/Changes ~ceived Application: /~ll~l~/{~_ ~.l~eived Fee:$ ~ ~.Completed Application Incomplete SEQRA Classification: Type I. Type II Unlisted Coordination:(date sent) Referral Sent: ~_~~ of Inspection: ~~_~ Receipt of CAC Report: Lead Agency Determination: Technical Review: ~o-blic Hearing Field: Resolution: Minor E~rd of Tr~stees Name of Applicant ALAN & TERESA MONTANO SUCHER Address 71 McCORD AVENUE, MERRICK, NY 11566 Phone Number: 516-223-6527 Suffolk County Tax Map Number: 10OO - 11 ! -1-6 Property Location: 60 FISHERMANS BEACH ROAD, CUTCHOGUE (provide I Jl.CO Pole #, distance to cross streets, and location) AGENT: LaN-CONSULTANTS, INC. (If applicable) Address: 1319 NORTH SEA ROAD, SOUTHAMPTON, NY 11968 Phone: 631-283-6360 Board of Trustees Appli~ Land Area (in square feet): 10,760 Area Zoning:. R-40 GENERAL DATA Previous use of property:RESIDENTIAL. Intended use of property: NO CHANGE. 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? X No Yes If yes, provide explanation: Project Description (use attachments if necessary): REMOVE AND REPLACE (IN-PLACE) APPROXIMATELY 168 LINEAR FEET OF EXISTING TIMBER BULKHEAD WITH VINYL BULKHEAD AND BACKFILL WITH APPROXIMATELY 75 CUBIC YARDS CLEAN SAND FILL TO BE TRUCK~f~ IN FROM AN UPLAND SOURCE. REMOVE AND REPLACE (IN-KINE)fIN-PLACE) EXISTING STEP-DOWN PLATFORM (AS NECESSARY) DURING CONSTRUCTION OF BULKHEAD, ALL AS DEPICTED ON THE PROJECT PLAN PREPARED BY EN-CONSULTANTS, INC., DATED 12/7/04. CONSTRUCT DORMER, DECK, AND CHIMNEY ADDITIONS TO AN EXISTING 1.5-STORY, ONE-FAMILY DWELLING, ALL AS DEPICTED ON THE SITE PLAN PREPARED BY HANDS ON SURVEYING, LASTED DATED OCTOBER 4, 2004. Board of Trustees ApplicOon WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: MAINTAIN EXISTING EROSION CONTROL STRUCTURE; HOUSE ADDITIONS. Area of wetlands on lot: 0 .square feet Percent coverage of lot: 0 Closest distance between nearest existing structure and upland edge of wetlands: +/-9 feet (GARAGE) Closest distance between nearest proposed structure and upland edge of wetlands: +/-20 feet (ATTACHED DECK) Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated? N/A Cubic yards How much material will be filled? +1-75 cubic yards Depth of which material will be removed or deposited: N/A feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: BACKFILL TO BE TRUCKED IN FROM UPLAND SITE, DUMPED, AND GRADED LANDWARD OF NEW BULKHEAD. 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): THE PROJECT ENTAILS (I) THE ORDINARY AND ROUTINE MAINTI~NANCE OF AN EXISTING BULKHEAD AND (2) THE CONSTRUCTION OF MINOR DORMER AND DECK ADDITIONS TO AN EXISTING DWELLING LOCATED LANDWARD THEREOF. THE PROJECT WILL HAVE NO ADVERSE IMPACTS ON THE ADJACENT TIDAL WATERS OR WETLANDS OF THE TOWN. 14-16-4 (2/~Texl t2 PROJECT I.D. NUMBER 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) SEQR I APPLICANT/SPON$OR:~j~[ ,6 TERES MONTANO SUCHER [ 2. PROJECT NAME I BY EN-CONSULTANTS, U~IC. 3 PROJECT LOCATION: Munl~f~lity CUTCHO~U~ County SUFFOLK 4 PRECISE LOCATION (~{~l~t address and road int~r~-ti4~tm, p~orrtln~nt landmarks, el[G, or provide map) 60 FISHEP. MANS BEACH ROAD, CUTCHOOUE, TOWN OF SOUTHOLD, SCTM #1000-111-1-6; MAP PROVIDED 6 DESCRIBE PROJECT BRIEFLY: REMOVE AND REPLACE ON-PLACE) APPROXIMATELY 168 LINEAR FEET OF EXISTING TIMBER BULKHEAD WITH VINYL BULKHEAD AND BAClGCILL WITH APPROXIMATELY 75 CUBIC YARDS CLEAN SAND FILL TO BE TRUCKED IN FROM AN UPLAND SOURCE. REMOVE AND REPLACE 0N-KIND/IN-PLACE) EXISTING S~EP-DOWN PLATFORM (AS NECESSARY) DURING CONSTRUCTION OF BULKHEAD, ALL AS DEPICTED ON THE PRO~,CT PLAN PREPARED BY :-'N-CONSULTANTS, INC., DATED 1277/04. 2ONSTRUCT DORMER, DECK, AND CHIMNEY ADDITIONS TO AN EXISTING 1.5-STORY, ONE-FAMILY DWELLING, ALL DEPICTED ON THE SITE PLAN PREPARED BY HANDS ON SURVEYING, LASTED DATED OCTOBER 4, 2004. DEC, COE, DOS 1. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLy VALID PERMIT ON APPROVAL? ~lYea [] No ff ye~, liet agency name and permit/approval 12. AS A RESULT OF PROPOSED ACTION V~ILL EXISTING PE~MITIAPPROVAL REQUIRE MODIFICATION? []-o I CERTIFYHAT~HETHAT HE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE AOpllcMit/~xm=or If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment I OVER Anita Samuels 155 Fisherman's Beach Road Cutchogue, NY 11935 I, Anita Samuels, own property known as 120 Fisherman's Beach Road (SCTM #1000- 111-I-8.2), Cutchogue, which is located west of and adjacent to that owned by Alan and Teresa Montano Sucher, whose property is known as 60 Fisherman's Beach Road. I am aware of and have n~ objection to the Suchers' proposal to remove and replace the portion of their bulkhead that extends over our mutual property line and ties into the bulkheading of my boat slip, all as depicted on the project plan prepared by Eh-Consultants, Inc., December 7, 2004. Dated: Anita Samuels NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEESe TOWN OF SOUTHOLD In the matter of applicant:Sd~N~T~F~SA MONTANO SUCHER SCTM#1000- Ill-l~ YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: REMOVE AND REPLACE (IN-PLACE) APPROXIMATELY 168 LINEAR FEET OF EXISTING TIMBER BULKHEAD WITH VINYL BULKHEAD AND BACKFILL WITH APPROXIMATELY 75 CUBIC YARDS CLEAN SAND FILL TO BE TRUCKED IN NE(~SSARY) DURING CONSTRUCTION OF BULKHEAD, ALL AS DEPIc iI~ID ON Tt~ PROJECT PLAN PREPARED BY EN-CONSULTANTS, INC., DATED 12/7/04. CONSTRUCT DORMER, DECK, AND CHIMNEY ADDITIONS TO AN EXISTING I.$-STORY, ONE-FAMILY DWELLING, ALL AS DEPICTED ON THE SITE PLAN PREPARED BY HANDS ON SURVEYING, LASTED DATED OCTOBER 4, 2004. 2. That the property which is the subject of Environmental Review-is located adjacent to your property and is described as follows: 60 FISHERMANS BEACH ROAD, CUTCHOGUE 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public comment on:J~u~-lgT~,2~5 ~7~ You may contact the Trustees Office at 765-1892 or in writing. The above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. OWNERS NAME: AL~ & T~$A MONTANO SUCHER MAILING ADDRESS: 71McCO~/)AV~NUE PHONE #: $16-223-6527 Enc.: Copy of sketch or plan showing proposal for your convenience. PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: VIOLET & ALBERT ROMERIL Address: 1265 VANSTON ROAD CUTCHOGUE, NY 11935 ANITA SAMUELS 1655 FISHERMANS BEACH ROAD CUTCHOGUE, NY 11935 JOYCE FRIEDLAND 52 RAYMOND PLACE HEWLETY, NY 11577 STATE OF NEW YORK COUNTY OF SUFFOLK ROBERT E. HERRMANN 1319 NOR'IT1 SEA ROAD SOUTHAMPTON, NY 11968 doing business at~N~ONSULTAJ~T~,~NC- · being duly sworn· deposes and says that on the 28th day of DECEMBER ,20 ~ , deponent mailed a true copy of the Notice set forth in the Board of 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 Notice~ were mailed at the United States Post Office at SOUT~L~u%~FO~ , that said Notices were mailed to each of said perso~ by (certified) mail. Sworn to before me this 28th day of DECEN~ER .ao ~ r~ '~ 'rot~P~t~,--" ~.,~ 12/L'~/04 ~ ~*o ' ~ta Samuels ~ [~c~ 155 Fisherm~ Beach Road  . Cutcho~e, NY 11935 USE r~ (Endo~emer~t Required) ~IT II): Clerk: 12/28/~ ~ ~ Violet & Albert Romeril ~.~. I 35 ..... $ 0.37 · 1.75 Joyce Friedland UNIT 19: Clerk: 52 Raymond Place Hcwlett, NY 11557 Albert J. Krupski, President James King. Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 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) AFFIDAVIT OF POSTING being duly swom, depose and say: /,- ,..- That on the "7 day of T/'ao' , 200'*, I personally posted the prop.erty known as by placing the Board of Trustees official poster where it'[an ea"'~l'~ly 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 heating. Date of hearing noted thereon to be held (1.1~.. ~It~tg. /~., t~O~ ' .._ · Dated: Sworn to before me this Iq-'~ day otC~ 200~ blic (signature) of Trustees Applioa~ AUTHORIZATION (where the applicant is not the owner) (print owh~r of property) (mailing address) (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. ( Owne~' s signature) 8 Board of Trustees Appliclon County of Suffolk State of New York ~ ~-~,~,~ - ~ ~,~..~ ~. ~ sE~a ~ULY SWO~ DEPOSES ~ ~F~S ~$ ~/S~ IS ~ ~PLIC~ FOR ~ ~0~ ~scm~ v~(s) ~ ~o ~ ~s~ o~ ~s~ ~o~a~ ~ ~m~, ~ ~r ~ wo~ ~L BE DO~ ~ T~ ~R SET FOR~ ~ mS ~PLICATION ~ AS MAY BE ~PRO~D BY ~ SO'HOLD ro~ BO~ OF TRUSSES. ~ ~PLIC~ ~o~ss To HOLD ~ TO~ O~ SO~O~ ~SSS ~ ~ ~aOM ~ Oa ~* m~ O~ Sm ~T(S), · a~D. ~ CO~ST~O ~S ~PLICAUON, I ~BY A~O~E T~ ~US~ES, ~ AGENT(S) OR ~ss~i~s(s), TO s~ OmO ~ ~ao,~a~Y ~o ~S,SCT T~ P~SES ~ CON~CTION ~ ~W OF ~S ~PLICA~ON. ~namre SWORN TO BEFORE ME THIS ,..~_f,~ DAY OF Notary Public APPLICANT/AGENT/R~PI~SENTATIV~ TRANSACTIONAL DISCLOSUI~ FORM The Town of Southold's Code of Ethi~ orohibRs conflicts of interest on the Dart of town officers and emolovees. The Dumosc of this form is to provide information which can alert the town of oossible conflicts of int~rast and allow it to take whatever action is nccesssrv to avoid same. (Last name, flrst'nk~n~-middle initial, unless you are applying i~ the name of someone else or other ~ntity, such as a company. Ifsu, indicate thc other person's or company's harry.) NAME OF APPLICATION: (Check all that apply.) Variance Change of Zone Approval of plat Exemption from plat or official map Other (If"Other", name the activity.) ~ ~'.T/, A 14'~ Do you porsonally (or through you~ company, spouse, sibling, parent, or child) have a relationship with any officer or employce of the Town of Southold? "Relation~ip" includes by blood, marriage, or business interest. "Business interest" weans a business, including a partnership, in which the town officer or ¢rc~loy~c has even a partial ownership of(or employment by) a corporation in which the town officer or empinyce owns more than 5% of thc shar~. YES NO ~ If you answerud "YE", 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 p~rson Dcscril~ the relationship between yoarscff(the applicant./agant/repr asantativ¢) and the town officer or employee. Either ch~:k the appropriatc line A) through D) and/or describe in thc space provided. Thc town officor or ~mployce or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of grea~r than 5% of the shar~ of the corporate stock of the applicant (when the applicant is a corpormioa); B) the l~al or beneficial owner of any inie~st in a non-corporate entity (when thc applicant is not a corporation); C) an o feet, dir~tor, parmer, or employee of the applicant; or D) the actual applicant DESCRIPTION OF RBLATIONSHIP 20oZS. EN-CONSULTANTS, INC. 1319 No~h Sea Road Southampton, New Yo~ 11968 631-283-6360 Fax: 631-283-6136 www.enconsultants.com ENVIRONMENTAL SERVICES December 28, 2004 Town of Southold Board of Trustees Post Office Box 1179 Southold, New York 11971 Attn.: Lauren Standish Re: Alan & Teresa Montano Sucher 60 Fishermans Beach Road, Cutchogue SCTM #1000-1 l 1-1-6 u~a0l ptouw, o~ Dear Ms. Standish: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: 3. 4. 5. 6. 7. Three (3) Wetland Permit Applications, (including Notice and Proof of Mailing to adjacent owners). Three (3) Short Environmental Assessment Forms. Three (3) copies of authorization & disclosure forms. Three (3) work plans. Three (3) copies of survey. One (1) set of site photographs. Application fee of $250,00. I trust this information shall allow you to process our permit request. Should any additional information be required, please do not hesitate to contact our office. S~ly, Ro~. H~n Coastal Management Specialist /khs Enc.