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Home My WebLink AboutTR-5841 " . . . ,. TERMS and CONDITIONS The I'ennittte JOHN J. & JOYCE A. SAMPlERl residing at 1380 Bayberry Rd.. Cutchogue. NY N. y...as pan. of the coosidetatiOll for cbe lsso',~ of cbe PCnnit does ....taod &nd poescribe to the fol- Iowlag : 1. That the said Board 01 Trustees and cbe ToWn 01 SoucboId are rdeased ftem 8l1Y and aU damages, or cWms foe damages, of suits ads1ag dlrecdr or lodirecd1 as a resuk of 8l1Y oper' ation pedolDlClCl pursuant to cbis permlt, and the laid 1'-. l"-t wi11, at bis or bet 0WIl ell' "=. &fead aoy aDd aU such ..uu.lnit/.ted'by chitd Fatties, and the said 1'-. I,,,~ ......-full UabIllq wiIh reSpect tbeteto. to.the completeexdusloo of the Board of Trasttes 01 the Town of So .t!.,1d 2. That cbis PermIt is nIid fOr _period of . 24 IDOl. wblch is llOosl' ,cd to lie the estimated time. ttqUlred to compl- the wod< in\'Ohed, but. ibooIJd cir(milstaDces WIIt1'I1IC, ~ . for an extemioo ma1 be made to the Board at a"law' ~ .. 3. That this Pennit should be retained indefmitel1. or as loog as the said Permittee ~ to . "'.I....ln the sttueture or project involved, to proTide evidence to aoyooe cooceroed cb>t auth- .orizatiOll was origitWl1 obtaioe<l "- That me worklaTolvcd will be subject to ibe in~ and appronl 01 the Board or Its agents, and DOIl-<lllO'{>Il.nn"wicb. the provisions 01 the otlglnoll'>g applicadon, -.., be c:aase fot rnocadOll of this Pamit by resoludoo of the said Board. 5. That tbe:e will be no unuasoMhle interf~ wicb na~ as a result of the work . . berdn miborized. . . 6. That cbere sba11 be no interference wicb the right 01 the puhlic to pass and repass aloog the beach betweea high and low _ter maries. . 7. That ilfucure operatioas 01 the Town of SoucboId nquire lbe JClDOft1 aod/Ot alcendoas . in the locatioo of the work berdn mtbo<V--l, or U. in the oplnlnn of the Board 01 T.-. the. work shall cause unreasoaahle obsttuctlOO to free naTigatioa, the said PermIttee will be RqUlred. npoa due noti<e, to raDOTe or alter cbis work or projea berdn stated wicboat g.j.et."s to the Town . 01 Soucbold. .. . 8. That cbe said Board will be notified by the Pamiuee ot the c:tXtIpledoo.: Of the work auth- orized. 9. Thu the Permittee will obWn aU other per:mits and ~~ chat .Day be required sup: plemental to this permit which ma1 be subjea to revoke upoa failure to obtain same. ..: ~ ./ . . 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 December 17, 2003 J. Kevin McLaughlin, Esq. Winds Way Professional Center 44210 Route 48 P.O. Box 1210 Southold, NY 11971 RE: JOHN J. & JOYCE A. SAMPIERI 1380 BAYBERRY RD., CUTCHOGUE SCTM#118-2-12 Dear Mr. McLaughlin: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, December 17, 2003 regarding the above matter: WHEREAS, J. Kevin McLaughlin, Esq. on behalf of JOHN & JOYCE SAMPIERI 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 South old, application dated November 25, 2003, 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 December 17,2003, 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, ----- 2 . . 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 JOHN J. & JOYCE A. SAMPIERI to construct first and partial second-story additions to the existing one-story residence and construct a 3.5 car garage at the easterly end of the property, and as depicted on the site plan prepared by Busch Associates dated November 20, 2003. 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 $5.00 per inspection. (See attached schedule.) Fees: $5.00 Very truly yours, b~~$ 9- ~-7r' J... t}. Albert J. Krupski, Jr. President, Board of Trustees AJK/lms Ul N W 0> W <Xl I- - (/)C~..... ~~!"~ Z 0 >' 3:rn Z o ~ ttl ~ .... 0 O:g u.. a:O o ~S lj C~~S a: ." C5 ~ lD - . . J. KEVIN MClAUGHLIN Attorney At Law Winds Way Professional Center 44210 Rt. 48, P.O. Box 1210 Southold, New York 11971 Telephone (631) 765-6085 Facsimile (631) 765-1856 December 22, 2003 Board of Town Trustees Feather Hill Complex Southold, NY 11971 Re: Application of John & Joyce Sampieri Premises: 1380 Bayberry Road, Cutchogue, NY Gentlemen: I have enclosed my check in the sum of $5.00 in payment of the inspection fee in the above-referenced matter. Ene. Hand Delivered i , Dollar. $ ~ '1, ~ AMT. PAID BAlANCE DUE 11~ ......... . ..J Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda . . Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: '10h-n<4--10JI(!f, uJatnpL.I"'li Please be advised that your application, dated "~~ has ~~enJreviewed by this Board, at the regular meeting of I CH 1'7 tl3 and the following action was taken: ( V") Application Approved (see below) (-) Application Denied (see below) (-) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is 'computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: .sISDD lNlPe~ fr-u- TOTAL FEES DUE: $ 5. Db SIGNED: tah~~ ~ ;/.c,. f..A..- 9; PRESIDENT, BOARD OF TRUSTEES BY: ~H", Jto.~J,. C ,BOARD OF TRUSTEES 4/98 ----- '" '" w <!) q "- o (f) :c, '" '"' ., en "- en '"' <T. ~ '" '"' eo " " ., " '" '" N " '" ,Y) " '" '" ~<v V~ <v~ "r" / ~~ <v~ 0v , /Y\.~EXISTING ASP~ALT DRIVE...AY / / \ .......: TO REMAIN - /,~O.f'-..., EXISTING NEIG/BORING " '. /. (? GREEN>-lOUSE I +- / ;'''.)'" l..v/ HI PRO ---", - POSED 720 CF CAPACITY STORM ,- / / - NATER LEACHING BASIN. CONNECT TO I ~ " ALL ROOF GlITTERS . LEADERS ' \ 3 REMOVE EXISTING FRONT DECK . '- 8'-&5~'(f- REPLACE wrrn NEW \$ ----- NEr~BORING DWELLING; EXISTING SHED AND CONe. PAD TO BE REMOvED co '" en ,- ".. co '" ~ '" '"' PROPOSED 250 CF CAPACITY STORM I-oIATER LEACHING BASIN, CONNECT TO ALL ROOF GUTTERS . LEADERS PROPOSED SINGLE STORY, 3 .12 CAR GARAGE, REMOVE +1- €o5 CU.YD. PROPOSED ASP~ALT DRIVEI'-IAY ~ ,"OP<RW "N' \ . m BACK U", \) . OT 119 ;./~</ .~" / ~ , "/ PROPOSED ONE STORY ADDITION WITH BASEMENT, l REMOVE +1- 2B2 CU. YD. EXISTING SINGLE STOR PORTION OF DI-oIELLING--' TO BE REMOVED. , '" " " ~ EXrSTING BOAT SHED TO REMAIN " '" '" ~, " ., ONE STORY ADDrTION EXISTING ONE STORY DI-oIELLING WITH PRDPosED ONE STORY ADDITIONS. EXISTING DECK TO REMAIN PROPOSED LOCATION OF ~AY BALES - EXISTING DECK AND PATH EXISTING 8ULK~EAD EXISTING DOcK ~ Ii'iiiJ (f?) Ii'iiiJ SITE PLAN '" ~~ Q.e QS -Q ::;'IQ ~~ g~ ~ ~ c:: G') N w = ~ ~ ~ Ii'iiiJ SCALE. N.T,s. Tlte AB<wz 8m:: Pl.AN P"'OP08.IU. 18 aAeED ON A DianA! ~ 0.. "'HE Lor SURVEY. lAST ~8m DA~ 8!P'TE:MDI!R 28, 2003. AS PRODUce In' PECONIO BUAVEYoRe, P.c. ~, "~I"': - , PROJECT: SAMPlE #032001-R22 NO, ISSUE/REVISION 1 BOAR OF TRUSTEES SUBMISSION 2 ZONING BOARD ~IEW 3 REVrSED SCOPE DWG No. BUSCh{l,ssociates -. " ",""_l -'I'" . , '~. :'/('1 ::J AI'~I'lp""IP' r 1,1, .c'.. , . L j- _.,t , _ , LOT AREA=44.615 SQn. 01'1 1.02 AC. LOT COVERAOE=12.." ZONe, ~.40 SCALE: 10=40'-0' DATE: AUGUST 30, 2004 DAWN. BY.: AS DATE 11120103 12/ 3 I113ll104 MR. & MRS. JOHN SAMPIERI 1360 BAYBERRY ROAD CUTCHOGUE, NY 11935 S.C.T.M.: 1000.118~2'12 83 V\'~S--,'A" -,r'.=n _. SA\' S~OR[ M,'. ':C(.I, 2 ':88~' . f./) SP-1 To 6." !:L. FAX 6 j) 060 969 ~?()C .0- OJ ~ OJ tt\ ~ -<.. 1J o )> \J (; IS' .~ 12/10/03 Field Inspection . . '''''' ""'ie,"",,, _ J!' '-~~ ~' ...,;,r;i'.'" ,,J;.~;. '"4l\ ~''''~ "- '~""'-""~i<I! 'lk '. o>.p;' ;" ~, 'if;'. -~*-. ....,.'s.> ~ ~ ' - -%:- Sa()'\p'Q~ \' 12/10103 Field Inspection . . . . Telephone (631) 765-1892 Town Hall 53095 Route 25 P.O. Box 1179 Southold, NewYorlc 11971-0959 CONSERVATION ADVISORY COUNCIL TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Monday, December 8, 2003, the following recommendation was made: Moved by Don Wilder, seconded by Tom Schlichter, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL WITH A STIPULATION of the Wetland Permit application of JOHN & JOYCE SAMPIERI to construct first and partial second-story additions to the existing one-story residence and . construct a 3.5 car garage at the easterly end of the property. Located: 1380 Bayberry Rd., Cutchogue. SCTM#118-2-12 The CAC recommends Approval of the application with the Stipulation all excavation is moved away from the water. Vote of Council: Ayes: All Motion Carried ,-~-~ ------ -.-~ , , I , , I '1-- ~ + ~- "~ -.~--- " ---1~'~' i ; Ii , -<=>-Z~-~"CO. o " .=: 8' il , : 1 i I i ..,' ',-;. 1?1 ! :~" ! )' ~i" '. Jl :'j, 6'~; ~n .,.e,; I ~~!' - ~ ' ~ E';: , 8ii ~' ~ , , "1.,' , l' . ~IW! ,. .~Hf ~ Ihl:r Illllli 'It,ll' l"iM! ;.IIIJ'I '11<'1 ' "llil hl!!f' ~ :iil!/, lWJI I ' , , , , ,II!II liili' !!!!IJ 111111 IdH. i~!!! I Iii :.~ i, I I ~ II i,III ,~. I, , I " l . II' !l,d -l Ili[ I '~I, ,~ r" !;:: Ii II i " ,IL': ra; mum illl1JTlJllJIfJ ITITillTInrrnnm ! i m r rrmrmmmn I nil mnn JOe", ,:!~ 1 m I r . I '"""J- "~.".''''''''''1I'!'11.. 08/30/200d ld:40 f:,3195?7955 BUSCH PA(3E 02 P'ROPO&tP 2!SO CF CAPACITY 9TORM WATEJIt I..EACHINQ. 8A5IN, CONNECT TO AL.L. I'tOOF GlJTTE"5 . L!A,OERS ~ Q.) ~ ~ fj Q b P'ROPOs.EO $INGiL..I STOR'I"j .a ~ CA GA~.QE, ~EMO'VE' i-/'" " C:U.YD, ....O_EO A~~"","T "RIVE""AT ~ P'~~EP ClN~ STORy ADCtTIQN wrTW SA&El'1I:NT I _ REMCN'E .../- :Hf;f Cv YD. ElCt$TIN~ _T ""."l TO "EMAtN ! 14' I 12'''<: 10' ,;{ " . \ ,\ '"\ ... \ ,$, ~ --...- NII~I~ l)wt:LL..I~ EXI9Tt~ 5/-liO ANa CONe_ PAl) TO BE REMc7V'I!O REMOVE EXI&T!N~ FRONT OE:CK . REPI..AGE WIT).! NEJ004 EXISTINc; ON! $TORT DHEl..LI~ Io'lI'ITw "R~EO ONE STORY ADOITION$. ~ EXl5TtNQ ClEO(, AAD !'"AT'" EXIS,TIN<; DeCK TO "EMAIN ~CPOSEI) lOCA"tIO!'ll ~ "'A'I" BALI!$ ~;~ A~; ~ ~ ~"~ iD So BoarftCdl"llu:llet::>, ..............,..NAN~.. --OfIlI...bIIm'Al...........OtrTMllJ LO'P .........lAM',.,.,......". "II. l.._.&........~ -~-~.......".G. LOT ......1IA-....1.1IQFT. 0fIt 1,OtAC.. LOT ~~E.,a,4" ZOft4I1: It..-o 8CAL5: 1 ..4O'~0" DAft: AUGUST 30, 20CM ~.~.f.. SP-1 elATE " . "., . tI3OlO4 MR. . MRS,.!QHN SAMPlERI 1380 8A'r1iIiRA'" ROAO CUTCHOQue, NY 1 1835 S.C.T.M.; 1000.1'fe.o2_'~ ..... 08/30/2004 14:4B 5319597955 BUSCH PAGE 02 IXI$TING SINGl.E .T~ ~TICNO'f a.olEU" TO M' JtJNOVm. ~OPOIoID ~ GI' CA..AGlTY ITOIV"l ~ TEl' I.IAC;HtNCI M&IN. c:oNNICT TO Au.. ~ GU'TTpe . L.I"~. 0) ~ 0) {T\ ~ ...( \ l 1J ..... Q b "-OP'OSI'D $l~L.1 "TORT, S'" GA ~1U41. JIIl:e:l"'DVl .,-- H el"I,ro. ~I!) A~~1' t)ftIV.....,. _ "". .TOIlY .A.DDtTtQN ltlIlTW "'HMaNT. I'IEI"D/I .,- ,. Cu. YD. ~~ V~ ~~ ~~ 9;---f \ , v~~ O .c.; , /, -----==-1X1&TINlI """"I..T CHlIIWWA'" / /:. TO 911:1""'IN , /.~ 1X'$T1NCi ""1~INQ / ,....*' ....- ,,~ L.OT II' ~ED T20 e" CA"~ITT ATOIItr1 ' / HATIIll LIAC:WI* BASIN. ~'eT TO , "'I.I.. "GlOP' tAliTQtS . UAOlIIle JIIl:eMOVI EKISTIHG ~T Oe:ac , JIUPL.ACe ....'TW NI!Jo'\I J:lttSTI""Go 80.'.'1 OWED TO~IN , ...." D'ISilNl; ONE STcMY ~r;t.L.NO WITW _ eNl STQIIItY .o\DOtTICHIo. . I'J(IIoTING DeCK TO IttMAIN - LCeA'TION QtfI !-tAT &.o\L" 1X18TINQ OEGl( AND ~ATN 1X15TJ!'rG euLlCWlAD EXISTING OOCIC N SITE PLAN Ic:AL.I'I N,i.&. Oft, . - DWONo. .=.Q!i..fAlf'ERI SP-1 cVfci1OOUi,",jy'1l1klS S.C.T ....: 100o."e.oz.1~ ....... --................ -.."'......-.v._,.. ..... ....,.. ............. .... _. l. ...-...~ -,.....911.... __"... LOt" .-...u.........IIGPT.... ,.oIAC. LCn'~ -.._,....'" -..- 8CAL.-= '-.4D'-o' DAno: AUQueT 30. _ 0R/30/200d 1d:40 .-.:- &31 %9795& BUSCH PAGE 02 PJt~ 2!0 GI' CAP"AGIT'Y STOIV1 JoUt.TEIII I..IAOaINCI MaiN, CONNECT TO Aw. JtOOfI GUTT~ . l-'A095 OJ ~ OJ l1\ ~ ...( \ ~ 1J " C) . J:> 10 ~_.o $I","" &TCIOT, S l< CA ~PU4I. III~I .,... H C.u,m. P"ROPO$IC A~AJ.T D"lvlkA'T D'f.'TI~ BCMoT DHI'O TO It!r1AtN ~~ ",'r' ~<+- .f 9;--r ~'r' (y , /7'-..----==-'IXI&TINlI _.T OIOIY&<~T / /\....: Tg1t''''',N , /.~r IXltoTl!lki NII~ING / /..." GIt"""""- , 'P .#"~ LOT 117 ~ '7':10 Cf' GApi.-.errr .TOIItM ..."...; /' / Ioo4"'TIIill.~l* eASfN. ~ TO I ~ ' "'L~ "OOfI' c:ArM'1M . UAOIRe "~E ~"TIN~ ~T DeCK , RV'I...ACE WI"" NEH IXISTINlS ONE STo..y ~r;t.Llp.iQ Io'oIITW ~ ONI STQIItT .4DOITt0N6. EXI.TINQ DICK TO .mAIN ~ LDe~1'IOl'Il ('JtfIl-iAY &ALa I)(f&TIHG DEGK AND PATW IEXISTI,. I!IULIQofIAD ~laTING ClOCK ~/' cr:; ~ H \W ~~;"I Up "-,, i' , t--) SITE PLAN I 01 '~!!n Board of Trustees ..... . ........ DWONo. .\.~~~~l SP-1 CUTciiQOOi,"Hv'iio& a.C.T .....; 1000-""'_1.2 ..--......,.,.,..,.~.. -_"''''''M.~_... ........... '-""....... ~ _. .IP\...-....~ .,......... 91111II'" __ItAL L01' ~"""1.lIQIIi'T. 0IIt 'AlAe. LG'I' CCIIV'""'I-a..'.... -"'- SCALa: ,....,000' QATII: AUGUST 30._ . . 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 APPLICATION FOR AN AMENDME :G~~:~ ~ DATE Auqust 30. 2004 Sou\llold 10wn Board 011'"5\0" John J. Sampieri & O~R JoycP A ,"mpipri PHONE (516) 741-5693 ADDRESS 111 Cherry Valley Avenue, M-19. Garden City. NY 11530 AGENT J. Kevin McLaughl in, Esq. Winds Way Professional ADDRESS Southold, NY 11971 PHONE (631) 765-6085 Center, 44210 Rt. 48, P.O. Box 1210 PROPERTY LOCATION 1380 Bayberry Road, Cutchogue, NY 11935 TAX MAP NO. 1000-118.00-02.00-012.000 h. I/WeJ. kevin McLaughlin, as agen"Tequest an Amendmentto Permit # 5841 pursuant to attached revised Site Plan for a one-story addition to the existing one-family residence. C9'rO if'fb\'b\\~ . , . . J. KEVIN MCLAUGHLIN Attorney At Law Winds Way Professional Center 44210 Rt. 48, P.O. Box 1210 Southold, New York 11971 Telephone (631) 765-6085 Facsimile (631) 765-1856 September 21, 2004 Southold Town Board of Trustees Town Hall Annex Main Road Southold, NY 11971 Re: Amendment Application of John & Joyce Sampieri Gentlemen: I have enclosed the signed Affidavit of Posting, along with three (3) domestic return receipts from adjacent property owners. Encs. ~ . . . Albert J. Krupski, President James King, Vice-Presiden~ 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 ofthe Application of ____.jDt\t\____~~_~r_~_S:l~m(------- COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, J. Kevin McLaughl in ,residingat 680 Old Orchard Lane. East Marion, NY 11g39 being duly sworn, depose and say: That on the gt hday ofSeptemberzoo 4, I personally posted the property known as 1380 Baybprry Roerl, rlltrhngll". MY (SCTM #1090 llg 2 12) 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 ofthe public hearing. Date of hearing noted thereon to be held W~. , "" 'l, Sworn to before me this ~dayof Sept200 4 Dated: September oU , 2004 ~<-9 ~ Notary Public LINDA J. COOPER Notary Public, State of New York r;" 4~2?563, Suffolk,!=OI~,.,2.00-'- ';(''":', ~~:':...;;'e5(.tec&iTltiCr.,,1. .IB03 1~' 5' I~.' .w< - :..,,~ ,," 5741559393 "'.'0'.."'0 JSAMPIERI 1'-.c."J.t'll"'''^-.I-4..>'.:If'1L.lI'j iIoat:d of 'ftUet:eell AtlPuC&uone PAGE Bl f....\.;l;t'.. (,l~ ,. "\I'.~...oa!UTIOIlJ (where the applicaat. is not the owner) I, ~oYce A. SalllP1er1 i (print owner of propertyl I ! ~n C1t.. MY 11S30 resicU.n9 at 111 Crerl'y Val'I>Y A.anue, M~19. (1Da111nv addre..)- do hereby autbox-1... J. Ke~\n M<;;levgh1 in (.....ent) to applY for perllitel" I from the I southold Board of Town T~te.. on my behalt. ~''- tl d'~n., ---J er JI signature .IOY . Imp,e,,' 8 . . NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES. TOWN OF SOUTHOLD In the matter of applicant: J. Kevin Mclaughlin, as & Joyce A. Sampieri agent for John J. SCT11# 1000-118.00-02.00-01?OOO YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: amend Southold Town Trustees Wetland Permit No. 5841 pursuant to the attached revised Site Plan. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 1380 Bayberry Road, Cutchogue, NY 11935 SCTM No. 1000-118.00-02.00-012.000 3. That the project which is subject to Environmental Review under Chapters 32, 37, and/or 97 of the Town Code is open to public comment on: September 22, 2004 . 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 South old and does not reference any other agency that might have to review same proposal. OWNERSNA11E: John J. Sampieri & Jovce A. Samoieri 11AlLINGADDRESS: c/o J. Kevin Mclaughlin, Esq., P.O. Box 1210, Snllthnlrl, NV l1Q71 PHONE#: (631) 765-6085 Enc: Copy of sketch or plan showing proposal for your convenience. D t'. ::r- 1."!ll:m~I' . ~ _~"~ckLl~id U1 Punt.lge : 5, D D o Return I=l.edept ,oee CJ (EndorS~lmerlt Required) CE.nified 1:09 o Restricted :lelil/elY 10ee rn (Endorsement Required) o ru Total Postage & Foes: $ --_. U.S. Postal Sery ceOM CERTIFIED MIL" RECEIPT (Domestic Mall Only; I 0 Insurance Coverage Provided) Posta,ge $ 0 Certified Fee 0 0 0 Return I~eciepl Fee (EndorseMent Required) 0 Restricted Delivery Fee tT1 (Endorsement Requirod) 0 ru Total Postage & Fees $ 4.42 ru , 0 ,0 I"'- ent To J;;/ - Dd. ~ ilimn_-~-_"<:.:_':'~r.::?'_mmm"'n~nClr_?~-{.;.-R-i.f_"'_~~"'.s: o/~:;;~~~:;J~nbm~~Q,_~_b:),I~_~n:nn~_nmn_n_ City,State,ZIP+4 C', ~ \5"3 Postage $ W~ 0 Certified Fee 0 2.30 D Flelum Reclepl Fee D (Endorsmnenl Required) 1.'/5 Here ~ 0 Restricted Delivery Fee Cl OO~ tT1 (EndorSE/menl Required) 08/311~ - 0 4.42 ru Total Postage & Fees $ ru ~ ;;l4!g~1:?~;~~V~~).'-~ff-~'~B- m_n_nmn__nnmmmm__nn..n...............~.....................m.. City, Sta.., ZIP+4 .... 1 _, I _ \ "-0 r v el....''';> 0 r t( t--J, Q)G-- .., o o ::r- U.S. Postal Service", CERTIFIED MAIL" RECEIPT (Domestic Mail Only; No Insurance Coverage Provided) IT' ::r- ..0 U1 N10., if l~ ~ A L Postago $ 0." USE ru o o I"'- o o o Return !'ledept Fee o (Endorsement Required) o Restrtcted Delivery Fee rn (Endorsement Required) o ru Cot1lfted Fee Total Postage & Fees . . PROOF OF MAILING OF NOTICE ATf ACH CERTIFIED MAIL RECEIPTS Name: Richard & Jane E. Downing Address: Eleanor S. Nohe & ors, as Trustees 1280 Bayberry Road, Cutchogue, NY 11935 SCTM #1000-118.00-02.00-010.000 43 W. 93rd Street, #14, New York, NY 10025 SCTM #1000-118.00-02.00-013.000 435 E. 57th Street, #14B, New York, NY 10022 SCTM #1000-118.00-02.00-011.004 136 wickham Road, Garden City, NY 11530 SCTM #1000-118.00-03.00-009.000 Myron & Julia M. Matlaw Lizabeth & Jennifer J. Burrell '. STATE OF NEW YORK COUNTY OF SUFFOLK J. Kev i n McLaughl in, residing at 680 01 d Orchard Lane, East Mari on, NY 11939 , being duly sworn, deposes and says that on the 31 st day of August , 20Q!.., deponent mailed a true copy of the Notice set forth in the Board ofTl1IStees 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 oiSouthold; that said Notices were mailed at the United States Post Office at Sou tho 1 d. NY. that said Noti ai' 0 of said persons by (certified) (tll~ mail. Sworn to before me this -3.1 Day of 0, '(j"....~ .20~ ..~ ~ ..-;~ Notary ~c . LYNDA M. BOHN NOTARY PUBUC, State of New YoIIc No. 01 B06020932 . Qualified In Suffolk County_ Term expires March 8, 20 D ~. J12l1B4 14: 4B 531 %g7g55 -. BUSCH PAGE B2 - .... C# CN'''''''TY 1IT0IV1 ......nft llAQiNCI MatH. c:cNNICT TO Au. IIIOClf' Gf.ITTI'IIte . LIAOEW.a fI'titOI'OSro "'NGL.I .Tc.y, ...lJi GA .' t;A1U4I. 1Il~1 .1- " CU.'fD. ~IO~'" DftIVJtootAT ~ .~TT UNI SET !lOCI< ~INI! , OT II" ""~/.... , I:~ ,"< / / , /' , ~<v y"f' -<..<vq.. :;.?"; ~... , <v"f' . cY , /Y\.~'IXI.T_ -"T DOl.......... / /..,.....: TOtll"",IH , ~T IX,.,.,,,,, ..._,.... / hI; ...._ ,':; LOT 117 1"RDI "'m .,. err cA,iA(ITY STOIItM ' / ""ATIlt LIACaoHNr; USfN. ~ TO , 4LI. JtOOfI' QlJ'M'IfItt . LIAOIIIta D'JSTlfC _T TO_ IIt!r'1CYI ElCI_TING ~ D!CIC . IUPL.ACr WITW ~ - '. ~..., IXI.TING ONI .TORT OWIUM """~ _ ""'. ,"TOIn' __. rJC'.TuoIO Dt<:K TO fttMAlN - l.DCA"~ Of' MAY .. AUG .1, ?~n4 ~~~~'W~ IXIBTtNlI OEK AND '-"TN IXlaTIHCI 8UUCWIAP 1)('8TING ClCICK I(AU', ftC.'T .s, Lor ....,......,. aGPT.... ,..UC. LO'I' OD\.~,...,...." -- &CAL8t ".*'-0' DATIl: "LIQueT 30. 204M ... SP-1 .. -....................... ---....~~-- WI'................. .... .J. .L,_-....~ -"--'..."1'_.... . . APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of South old's Code of Ethics orohibits conflicts of interest on the Dart of town officers and emolovees. The DurooSC of this form is to orovide information which can alert the town ofoossible conflicts of interest and allow it to take whatever action is necessarY to avoid same. YOUR NAME: J. Kpvin M~I.lIghlin (Last name, first name, middle 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: (Ch""k all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat or official map Other (If "Other", name the activity.) Amendment to Southol d Town Trustees Wetl and Permit No. 5841 Do you personally (or through your company. spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of South old? "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 x NO Uyou answered "YES", complete the balance of this fonn and date and sign where indicated. Name of person employed by the Town of South old Karen A. McLaughl in Title or position ofthat person Oi rector of Human Resources Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) andlor describe in the space provided. The town officer or employee or his or her spouse, sibling, paren~ or child is (ch""k all that apply): _A) 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 --2L-D) the actual applicant DESCRIPTION OF RELATIONSHIP karen A. McLaughlin is the wife of J. Kevin McLaughlin, the agent for the owners J. KEVIN MClAUGHLIN . . . Attorney At Law Winds Way Professional Center 44210 Rt. 48, P.O. Box ]210 Southold, New York 11971 Telephone (631) 765-6085 Facsimile (63]) 765-1856 August 31, 2004 Southold Town Trustees Southold Town Annex Main Road Southold, NY 11971 Re: Application of John J. & Joyce A. Sampieri for Amendment to Permit No. 5841 Premises: 1380 Bayberry Road, Cutchogue, NY (SCTM #1000-118-2-12) Gentlemen: I have enclosed the original and two (2) copies of the Application for an Amendment to a Permit, along with my check in the sum of $50.00 for the filing fee herein, Notice to Adjacent Property Owners with Proof of Mailing and the Transactional Disclosure Form. Kindly calendar this matter for your meeting on September 22, 2004. [5), E C E IlJI " ~ l\ru AUG 3 1 2004 l~ Southold Town Board of Trustees . . 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 Office Use Only , ~ \ J t) \ O~ t:r, ~U-~ t J,\[t{W2.1. ~ bo-lLo _Coastal Erosion Permit Application ~elland Permit Application ~ Major Minor W aiver/ Arnen11i:r~rt5s _~ceived Application: ~ceived Fee:$~ ...6ompleled Appl;cation~ _Incomplete SEQRA ClasSlfical1on: Type I_Type II_UnJisted_ ~Coordmation:(date sent) JAC Referral Sent:~ ~te ofInspection:~ _Receipt ofCAC Report: ~ Lead Agency Detennination:_ Technical Review: ~lic Hearing Held:~ Resolution: Address III Cherry Valley Avenue, M-19, Garden City, NY 11530 ^1~ 9~~; Name of Applicant John J. Sampieri and Joyce A. Sampieri PhoneNumberf(16) 741-5693 Suffolk County Tax Map Number: 1000 - 118.00-02.00-012.000 o ~~nWl~rR1 NOV 2 5 2003 ,~ Property Location: 1380 Ba berr Road (provide LILCO Pole #, distance to cross streets, and location) AGENT: J. Kevin MClau9hlin, Esq. (If applicable) Southold Town Board of Trustees Address: Winds Way Professional Center, 44210 Rt. 48. PO Box 1210. Southold, NY 11971 Phone: (631) 765-6085 . . Board of Trustees Application GENERAL DATA Land Area (in square feet): 44,615 sq. ft. R-40 Area Zoning: one-story single family dwelling with decks, shed, boathouse Previous use of property: and dock first and partial second-story additions to existing residence Intended use of property: and construction of a 3.5 car garage Prior permits/approvals for site improvements: " Date 2/16/78 BP#9619Z for addition to 1 family dwelling 1/23/95 BP#22571 to alter existing boathouse, incl. bathroom 2/21/95 BP#22598 for "as-built" storage shed 10/21/96 BP#23764 to construct a deck Agency Southold Building Dept. " " _ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No - - ~lIanH~ 0 If yes, provide explanation: NOV 2 5 2003 ~n"thold Town Board of Trustees Project Description (use attachments if necessary): construct first and partial second story additions to existing I-story residence and construct 3.5 car garage at the easterly end of the property near Bayberry Road. . . Board of Trustees Application WETLANDffRUSTEE LANDS APPLlCA nON DATA Purpose of the proposed operations: Consturct first and partial second story additions to existing I-story residence and construction of 3.5 car garage Area of wetlands on lot: N I A square feet (property is bul kheaded) Percent coverage oflot: % Closest distance between nearest existing structure and ~ bul khead ~lI~ll~llMlllldll: appox. 5 feet Closest distance between nearest proposed structure and ~~ bul khead M!!;ll~lltlllM~: 61 '2" feet Does the project involve excavation or filling? No x Yes If yes, how much material will be excavated? 183 cubic yards (see attached Si te Pl an) How much material will be filled? cubic yards (backfill around new foundation area Depth of which material will be removed or deposited: approx. 8' feet Proposed slope throughout the area of operations: see attached Site Plan Manner in which material will be removed or deposited:backfi 11 remainder of fill offsite around new founda & truck ~ t 1:2: :~" ~ Statement of the effect, if any, on the wetlands and tidal waters 0 reason of such proposed operations (use attachments if appropriate): No anticipated effect on wetlands. Row of haybales to be placed prior .to construction, old 10"" Board 01 1lustees n t at may result by as shown on Site Plan. J. KEVIN MClAUGHLIN . . Telephone (631) 765-6085 Facsimile (631) 765- I 856 Attorney At Law Winds Way Professional Center 44210 Rt. 48, P.O. Box 1210 Southold, New York 11971 December 17, 2003 Southold Town Board of Trustees Feather Hill Complex Southold, NY 11971 Re: Application of Sampieri for Wetlands Permit Premises: 1380 Bayberry Road, Cutchogue, NY Gentlemen: I have enclosed the Affidavit of Posting and Notice To Adjacent Property Owners with Proof of Mailing in the above-referenced application, which is scheduled for a public hearing this evening. I have also enclosed the Certified Mail Receipts and the Return Receipts, which I have received. Encs. Hand Delivered ~ E D~C ~ 7' ~J ~ ~ Southold Town Board of Trustees . . 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 __~~_~__~__~~i~~_~~~~~g"n_______ COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING ~ J. Kevin McLauqhlin ,residingat 680 Old Orchard Lane. East Marion. NY being duly sworn, depose and say: That on the 2nd day ofDecEl1lber ,2003, I personally posted the property known as 1380 Bayberry Road, Cutchogue, NY (SCTM #1000-118.00-02.00-012.000) 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 ~~"t'O ~~ d ~ ~M ~ - Or\ cr CU--t., m, Dated: December 16, 2003 Sworn to before me this Ii., day of Dec. 2003 ~ mhO ot ublic LYNDA M. BOHN NOTARY PUBLIC, State of New YOlk No. 01 B06020932 Qualified In Suffolk County Term Expires March 8, ~J U ~ ~ o~c ~ : ~~ ~ Southold Town Bfl:1rrf n-'" '. . . NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: John J. Sampieri & Joyce A. Sampieri SCT~# 1000-118.00-02.00-012.000 by J. Kevin McLaughlin YOU ARE HEREBY GIVEN NOTICE: . I. That it is the intention of the IIDdersigned to request a Permit from the Board of Trustees to: We~la~d Permit to cons~ruct first and partial second floor additions to an eXlstlng I-story dwelllng and to construct a 3.5 car garage 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 1380 Bayberry Road, Cutchogue, NY 11935 SCTM #1000-118.00-02.00-012.000 . 3. That the project which is subject to Environmental Review under Chapters 32, 37, and/or 97 of the Town Code is open to public comment on: Oecember 17, 2003 . You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is IIDder review of the Board of Trustees of the Town of South old and does not reference any other agency that might have to review same proposal. OWNERS NAME: John J. Sampieri & Joyce A. Sampieri ~AILINGADDRESS: 111 Cherrv Valley AvpnllP M_lq. Garden City, NY 11530 PHONE#: c/o ,1. Kpvin Mrl."~hli~, Es~. (631) 765 6085 Ene: Copy of sketch or plan showing proposal for your convenience. .. . . . PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Richard& Janet E. Downing Address: Myron & Julia M. Matlaw 1280 Bayberry Road, Cutchogue, NY 11935 SCTM #1000-118.00-02.00-010.000 43 W. g3rd Street, #4, New York, NY 10025 SCTM #1000-118.00-02.00-013.000 ~arl H. Schultheis, Sr. & ano. P.O. Box 987, Cutchogue, NY 11935 SCTM #1000-118.00-03.00-009.000 STATE OF NEW YORK COUNTY OF SUFFOLK J. Kevin McLaughlin , residing at 680 01 d Orchard Lane, East Mari on, NY 11939 , being duly sworn, deposes and says that on the a-v-e. day of~e"""ro..v- . 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 South old; that said Notices were mailed at the United States Post Office at Southol d, NY , that said Notices re mailed fsaid persons by (certified) (r~!\i!I!~ mail. Sworn to before me this \ /. , . Dayof ~ .20~ ~ r,& YI1 (?JL - Notary Public . LYNDA M.BOHN. NOTARY PUBLIC, Slale of N..w'lbltl No. 01 B06020932 '. . Qualified in Suffolk County~ Term Expires March 8, ,a U . . Board of Trustees Application County of Suffolk State of New York J. KEVIN MCLAUGHLIN BEING DULY SWORN DEPOSES AND AFFIRMS THAT HFlSHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF illSIHER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN TIDS APPLICATION AND AS MA Y 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 TIDS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENT A TIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH RE W OF S LICA TION. DAY OF November 2003 '- SWORN TO BEFORE ME T , ~'Xd'-~( ~VU)r) otary Pub Ie UND!",,;. !~.('::~' . ~ NoMry Public, Slate, o~ N,~.n V~~:)(t.. Nn:.,~ ?7-?'~-~?':,S~:! l~i.k}A~,!n~::CliJO & ""..,..-..~ .~~,. - ," "'_,'; ,J..""',,i., ";,.)'_,. .."' I. ::e H'.'-", ,.....,.. "._ .'.'_ ~ ~ N~V ~ 5~ U ~ Southold Town Board of Trustees . . ,'. Au.-ZUTtOlf (where the applie&~t i. Dot ~he owner) I, joyce~. Sampi er1 (pt'lnt owner. of propenyl residi.n.g at 111 Cl'erry V all ~y A,po"t. ~-19. (IulTIng addrell8)- ~rd~n ell', NV 11530 , do hereby authori... J. (HI" "~~1l1 H. ("qent l to applY for perai~(&) from the sou~hold Board of TQWn Truate.. O~ my behalf, ~~-~!-r. tl ~~<"- ~ Ii /,(. er J> .i<)na~ure . oy~ . ampler' 8 ~~:"~:u~ Southold lawn Board ot 1rustees . . . ~ H-H).4 (2187)- iext 12 I PROJECT I.D. NUM8Eil 517.21 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) ,. APPLlCANT,SPONSOR John J. Sampieri & Joyce A. SEe I 2. PAOJEC7 NAME Municipality , TCM\1 of Southold County Suffolk "'. PREC:SE LOCATION (Street address and road intersections, prominent landmarkS. elc.. or proviae map) 1380 Bayberry ROad, Cutchogue, NY (SCTM #1000-118.00-02.00-012.000 5. IS PROPOSED ACTION: o New 0 Expansion [J Modification/alteration 6. DESCRIBE PAOJECT BAIE"LY, construct first and partial second floor additions to €Xisting I-story residence and. construct 3.5 car garage 7. AMOUNT OF U-ND AFFECTED: Initially acres Ultimatelv 44,615 sq. ft. acres I 3. WILL ,~RO?OSEi) ACTION COMPLY WITH CXISTING ZONING OR OTHER EXISTING '..AND uSE RESTRICTIONS? C Yes ~ No It No. descrobe b"efly an area variance will be required for the construction of the partia I second floor addition for a sideyard variance. ! 19 I I i VJHA T 1$ ?RE3E~T LA/"~iJ USe IN VlC1NlrY OF PROJECT? ~ ReSidential U,!ncustriaJ 0 Commercial 0 Agriculture ;--1 ParklForestlOOen 5cace Desc"be, existing I-story residenc with decks, shed boathouse and dock l......Otl1er jO. DOES ACTION INVOLVE A P~RMIT APPROVAL OR FUNQING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAl STATE OM LOCALl? c:'lYes 0 No If yes. list agency(s) and permil/approvals need area variance fran Southold Town Board of Appeals and building pennit fran Southold TCM\1 8uilding Department '::r- 11. DOES ANY ASPECT OF THE ACTlOl4 HAVE A CURRENTLY VAllO PERMIT OR APP o Yes' ~ No II yp.s, list ageracy name and permiUapproval o FE'rr: FE U W FE 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REOUI o Yes ~No lFIC t:fQ1'-I? 0:1 Signature: If the acti is in the Co"slal MBa, and 'fou are a slate agency, complete the Co tal Assessment Form before proceeding with this a~~essment UE'TO TH__ Y KNCWL::O ollthold To Board of 7:' Wn rustees ate: Applicant/sponsor name: OV'OR . PART ll_~N'J1RONMENTA.SScS.sMENT (70 be c::lf":'::::ietaa:y .Age:lC'. . I ..:.. C:CES AC7:C,~ =:;'':CZ='::::: :"NY L ,.~~, 7r-.RE5HOLJ!N 5 NYC?R. ;'.;;;7 3>7. ~Z? :/ '/es. .:ocrClnata :ne rg'VI~'N ::rcces~ ano 'Jsa :r.e .=:JL:... ~"A'= ! :-"-:''f~5 1_ ,~o , [I :. WILl... .:..C7:CN .~E::~:v~::CRalNA7~:) .~E'I'EW....5 ~RC'JIDE:) ,=':M UNLSTEJ .:.C7;CNS iN 5 .\JYC;::::R, :1.<1.;:;'7 ';;7.5<' ,I ,'~a. 3. ;"1e';3.l:va ~!!c:ar.o. ;r,ay Cle sucersecec ~y ..nc[..er ;nvolveo a<;ency. I 1--.,; ves :---.: ~o c. C::::ULD ..:..C7:CN .:J.E5UL7:N ...I.NY ,.l..DVE;::;SE =.:=:::SC'iS ..l.SSCC:A7E:Q '.v17~ -:-:E ;=OU..CWING; :).nswers :nay:e ,uncwnt:en. I :e";Ii::lcl C1. ~~isllng lit euald'(. :;urtac~ Of' <JrOunowacer :::uality ~r :::t:anllly, ,101se :e'/eIS. ~;l:.:Sllnq :,aUic :alterns, ,;cliO .vaste :Jrcc\,;c::::n Jf :lIs.:: ootenl1al lor ~rosion. :::ralnaq& or ~Iooding ;lfoOlems? =..:~claln ::lrieily: C2. Aesthetic, agric:.Jllural, lrC:1aeoloqical, his.orlC, ~r Olher :'lal:.Jfal Jr cullur31 ;esources:or -:ommunlly ~r :'1eHpCcrnccc: "::':Qrac:2r" ~O[3li' ~ C:J. '/ege!aIlOn or ~auna. :lsn. sr:ellflsn or '''lldllfe scecies. .'Hgmiicanl :"\aoilats. or :nreatened or ~ncan~ereo scec:es? Scla,n :;rlally: C":'. A c:;:mmunity's exis~:ng ;:llan:s or goalS as oltlc:aliy adooted. or a cnange in use or intensity oi use at !and or olher natural resourc8s7 S~olaln :: C:5. Glowlh. SUQseouent:eveloomenl. or related ac:ivilies likelY (0 oe induceooy !ne ::rccoseo action? S~otaln ;Jneflv. ':3. I_cng :erm, snort :erm. -':::.Jmulatjve. or ottler ~Ifec:s not icemified in C,,;.':;3? =;(013In :>nerl'!. St:':er :moac:s dnc:..Jc:nq ::::anqes In 'J!e of ,!tther quantity .~r :yce Of ~nergYl? =-'(:)13m :flell'l. 'J. S :-:';E:='E, ::;A is 7i-iE~E '_::<:=::..::' 70 3E. CONT~OVE.~S'! :!,ELA7Ea TO ?QTENT1AL ":'8VS.::l,SE =:'IVIRONME:'~7;'L :,',~P~C";-S? _~es '_.'10 :f '~es. ~xc!ain ~r1etly o~~\E~~LEM\\ ?ARi III_DETeRMINATION OF SiGNIF1CANC~ (To oe comoleted by Agency , ' INS7RUC710NS~ For eac:! adverse effect identified aCove. determine whetner it is s ta ial, large, ;mcortant Or otn =.ac:1 eifect Si10uld be assessed in connection wiln its (a) setting (Le. urban or r r31); ( ) ;Jrobacil' irre'/erslbllity; (el geogracnic 3ccce: and (f) magnitude. If necessary, add attacnmen s or r eren$l~~ eXOlanaticns c:::ntain sufficient delail to snow that all relevant adverse impacts hay been idenfitfi'i!ib:Aa,r~.~ ' rNiSe , lei materials. ignif ratio :1sur; esse, C;'eCl< .his box ;f you i,ave identified one or more ,::otenriaHy lar~e or signilicant cG';erse imaac:s wnlC;1 ,l,L oc::ur. Then ,:Jrcceeo direc:ly to ~he ;=ULL EA;= and/or prepare a positive'declaraticn. C~ec~< ~his :;ox if you have determined, oasad on the information and analysis above and any sucoort;; coc:.:r7ientatlcn, :h2I ~he prooosea ac:ion WILL ~~OT result in~f1Y significant adverse environmenrc.J imcac AND ,J(OV1Ce on 3.i:!ac:1ments as necessary, {he (easons supcorting [his determination: ....,,"'~, (,H ~",~O.J ,...>,;",nC"( ~"nl .J/ ~!:t:' -,:,.IT''!' .)1 {~',oon\'OI'" ~11l(~r ,(l .........0 ."o;","C'1 ;,tlt:' -:)1 ,.("0000\'011:' VII"<>( ""n.)I\,;/(' )l ~..~ccn"OIe' _1:'CN.n -.....JO ,~"...",y )',<,,<l:U'" )f r"~:J.,l'l!'r \Ir ~,l;"'..nt :rom .",~oon"o'~ JI"C~fl .),J[(:' 2 . . APPLlCANT/AGENTIREPRESENT A TIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nrohibits conflicts of interest on the Dart of town officers and emelavees. The Durnase of this form is to orovide information which can alert the town ofoossible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: r-tLaughl in. J. Kevin (Last name, first name, middle 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 Variance Change of Zone Approval of plat Exemption from plat or official map oo~ . (If "Other", name the activity.) Southold TCI/'Il1 Wetlands Penmt 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 x 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 South old Karen A. r-tLaughl in Title or position of that person Director of Hu1'an Resources 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): _A) 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 t~ applicant is not a corporation); 0 _C) an officer, director, partner, or employee of the applicant; or ~D) the actual applicant. ~I:~ ~ U W ~ ~ DESCRIPTION OF RELA TrONSHIP Karen A. r-tLaughlin is ~ wife. Southold Town Board of Trustees . . APPLICANT/AGENTIREPRESENT A TIVE TRANSACTIONAL DISCLOSURE FORM The Town of South old's Code of Ethics r hi i c this form is to rovide information which c alert necessary to avoid same. iets of interest on the art of town officers and em 10 ees. The u ose of town of ssible conflicts of interest and allow it to take whatever action is YOUR NAME, r-tLaughlin. J. Kevin (Last name, first name, middle 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 Variance Change of Zone Approval afplal Exemption from plat or official map OOer . (If "Other", name the activity.) Southold TC/I/I1 Wetlands Penmt 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, mcluding 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 x 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 South old Karen A. r-tLaughl in Tille or position of that person Director of Huran Resources Descnbe 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): _A) 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 ::l ~ applicant is nor a corporation); rc: ((U ~ fi '\\f1 ~ D _C) an officer, director, partner, or employee of the applicant; or ~u; \l.D Lr;.. U '0J ;::I ~D) the actual applicant. \ , DESCRIPTION OF RELATIONSHIP Karen A. McLaughlin is my orife. Sout\"lo\d lown oard Ql1rus\ees . . APPLICANT/AGENTIREPRESENT A TlVE TRANSACTIONAL DISCLOSURE FORM The Town ofSouthold's ode of Ethics lohi its co jet of interest on the art of town officers and em 10 ees. The u ase of this form is to rovide information which c alert the t wn of ossible conflicts of interest and allow it to take whatever action is necessarv to avoid same. YOUR NAME ~Lauahlin. J. Kevin (Last name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a company. Ifso, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat or official map ~er . (If''Other'', name the activity.) Southold TOiIll Wetlands PerTmt Do you personally (or through your company. spouse, sibling, parent, or child) have a relationshIp with any officer or employee ofrhe Town of South old? "Relationship" includes by blood, marriage, or business interest. "Business interesr" 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 rown officer or employee owns more than 5% of the shares. YES x NO If you answered "YES", complete the balance of this fonn and date and sign where indicated. Name of person employed by the Town of South old Karen A. ~Laughl in Tille or position of that person Director of Hunan Resources 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); _A) the owner of greater than 5% of the shares of the corporate stock or 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. ~~ ~ lE; U \H~ DESCRIPTION OF RELATIONSHIP Karen A. ~Laughlin is my wife. .... . . J. KEVIN MClAUGHLIN Attorney At Law Winds Way Professional Center 44210 Rt. 48, P.O. Box 1210 Southold, New York 11971 Telephone (631) 765-6085 Facsimile (631) 765-1856 November 24, 2003 South old Town Board of Trustees Feather Hill Complex Southold, NY 11971 Re: Application of Sampieri for Wetlands Permit Premises: 1380 Bayberry Road, Cutchogue, NY Gentlemen: I have enclosed the original and two (2) copies of the Application, Authorization, Short Environmental Assessment Form, Transactional Disclosure Form, survey and site plan, along with my check for the filing fee herein. Please place this matter on the next available date. Encs. Hand Delivered IlBJ re ~ re ~ Wi re ,fFj) Ifll NOV 2 5 200J ~ Southold Town Boanl of Trustees