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Home My WebLink AboutTR-6502 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hail Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD CERTIFICATE OF COMPLIANCE # 0438C Date June 19, 2009 THIS CERTIFIES that the two one-story additions to the existing two-story dwelling, gutters and drywells, foundation w/crawl space, retaining walls, ~arden and porch At 3180 Mill Lane, Peconic Suffolk County Tax Map #67-3-1 Conforms to the application for a Trustees Permit heretofore f'ded in this office dated 11/13/06 pursuant to which Trustees Wetland Permit #6502 Dated 12/13/06 was Issued and was Amended on 8/22/07 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 two one-story additions to the existing two-story dwellino~ cutters and drywells, foundation w/crawl space, retainin~ walls, ~arden and porch, The certificate is issued to HUGH LEE SWITZER IRREVOCABLE TRUST owner of the aforesaid property. Authorized Signature Jame~ F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall, 53095 Main Rd. P.O. Box I 179 $outhold, NY 11971 Telephone (63 I) 765-1892 ' Fax (631 ) 765 -6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: t~Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bate line/silt boom/silt curtain st day of construction constructed V//'Project cOmplete, compliance inspection. INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen ]~ob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 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 ½ constructed Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6502 DATE: December 13~ 2006 ISSUED TO: HUGH LEE SWITZER IRREVOCABLE TRUST PROPERTY ADDRESS: 3180 MILL RD. PECONIC SCTM#67-5-1 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on December 13, 2006, and in consideration of application fee in the sum of $250.00 paid by Hugh Lee Switzer Irrevocable Trust and subject to the Terms and Conditions as stated in the Resolution, the Trustees authorizes and permits the following: Wetland Permit to construct two one-story additions to an existing two-story dwelling located no closer to the wetlands than the existing structural areas, with the condition gutters and drywells are installed to contain the roof run-off, and a line of staked hay bales is placed down before any activity begins and maintained throughout construction, and as depicted on the survey prepared by Stanley J. Isaksen, Jr., last dated October 16, 2006. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittee Hugh Lee Switzer Irrevocable Trust, residing at P.O. Box 283, Peconic, NY, as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and ail damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if furore operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Department of Real Properties Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 December 13, 2006 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Robert E. Herrmann En-Consultants, Inc. 1319 North Sea Rd. Southampton, NY 11968 RE: HUGH LEE SWITZER IRREVOCABLE TRUST 3180 MILL RD., PECONIC SCTM#67-5-1 Dear Mr. Herrmann: The Board of Town Trustees took the following action during its regular meeting held on Wed., December 13, 2006 regarding the above matter: WHEREAS, En-Consultants, Inc. on behalf of HUGH LEE SWITZER IRREVOCABLE TRUST applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated November 13, 2006, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the Board of Trustees has furthered Policy 6 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the installation of gutters and drywells to contain the roof run-off, and a line of staked hay bales during construction activities, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on December 13, 2006, 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 275 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 for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of HUGH LEE SWITZER IRREVOCABLE TRUST to construct two one-stow additions to an existing two-stow dwelling located no closer to the wetlands than the existing structural areas, with the condition gutters and drywells are installed to contain the roof run-off, and a line of staked hay bales is placed down before any activity begins and maintained throughout construction, and as depicted on the survey prepared by Stanley J. Isaksen, Jr., last dated October 16, 2006. 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, President, Board of Trustees JFK/Ims Telephone (631) 765-1892 Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 CONSERVATION ADVISORY COUNCI~L~ TOWN OF SOUTHOLD At the meeting of the Southold Town Conservation Advisory Council held Wed., December 6, 2006, the following recommendation was made: Moved by Don Wilder, seconded by Jack McGreevy, it was RESOLVED to SUPPORT the Wetland Permit application of HUGH LEE SWlTZER IRREVOCABLE TRUST to construct two one-story additions to an existing two-story dwelling located no closer to the wetlands than the existing structural areas. Located: 3180 Mill Rd., Peconic. SCTM#67-5-1 Inspected by: Don Wilder, Jack McGreevy The CAC Supports the application with the Condition drywells and gutters are installed to contain the roof run-off and stringent run-off control measures are taken during construction. Vote of Council: Ayes: All Motion Carried James F. King, President Jill M. Doherty, Vice-President Pegg-yA. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095Route 25 P.O. Box 1179 Southold, New York11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Southold Town Board of Trustees Field Inspection/Worksession Report Property Location: SCTM# a Street Brief Description of proposed action: _T_~sse of area to be impacted: altwater Wetland Freshwater Wetland Distance of proposed work to edge of above: .~o~72,~ P__~cOf Town Code proposed work falls under: hapt.97 Chapt. 37 other Type of Application: 'V/Wetland __Coastal Erosion __Amendment __Administrative __Emergency Sound Front Bay Front Info needed: Modifications: Present Were: __J.King __J.Doherty ]~.DiCkerson Other: D. Bergen Bob Ghosio, Jr. Mailed/Faxed to: Comments of Environmental Technician: Date: /, PLANNING BOARD MEMBERS JERILYN B. WOODHOUSE Chair KENNETH L. EDWARDS MARTIN H. SIDOR GEORGE D. SOLOMON JOSEPH L. TOWNSEND PLANNING BOARD OFFICE TOWN OF SOUTHOLD MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 OFFICE LOCATION: Town Hail Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY Telephone: 631 765-1938 Fax: 631 765-3136 To: Jim King, President Town of Southold Board of Trustees From: Mark Terry, Senior Environmental Planner LWRPCoordinator DEC - 1 2006 Date: December 1, 2006 Re: Proposed Wetland Permit for HUGH LEE SWITZER IRREVOCABLE SCTM#1000-67-5-1 HUGH LEE SWITZER IRREVOCABLE TRUST requests a Wetland Permit to construct two one-story additions to an existing two-story dwelling located no closer to the wetlands than the existing structural areas. Located: 3180 Mill Rd., Peconic. SCTM#67-5-1 The proposed action has been reviewed to Chapter 268, Waterfi'ont Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is INCONSISTENT with the denoted following Policy Standards and therefore is INCONSISTENT with the LWRP. I Policy 6 Protect and restore the quality and function of the Town of Southold ecosystem. 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The proposed distance from the west addition to the marine wetland boundary is 93.1 feet. The distance from the east addition to the marine wetland boundary is 71.7 feetl a minimum setback distance of 100 feet is required pursuant to Chapter § 275-3. Findings~ purposel iurisdictionl setbacks. Please require that the applicant amend the application to meet the above policy to the greatest extent possible. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. · Albert J. Krupski, Pres~t James King, Vice-Prest~l~t Henry Smith Attic Foster Ken Poliwoda BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765 - 1892 Fex (631) 765-1366 Office Use Only Coastal Erosion Permit Application t.,,"Wetland Permit Application Major Waiver/Amendment/Changes , .-RYeceived Application: ! , ,~Received Fee:$ ~12) '/ ..... -~Tompleted Application I Il ..... Incomplete ,,, SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) ~'~CAC Referral Sent: -'--Date of Inspection: Receipt of CAC Report:' Lead Agency Determination: Technical Review: .~Public Hearing Held: t' Resolution: Minor Name of Applicant HUGH LEE SWITZER IRREVOCABLE TRUST AddressC/O HUGH SWITZER, TRUSTEE; P.O. BOX 283, PECONIC, NY 11958 Phone Number: 404-266-9311 Suffolk County Tax Map Number: 1000 - 67-5-1 Property Location: 3180 MILL ROAD, PECONIC (provide LILCO Pole #, distance to cross streets, and location) AGENT: EN-CONSULTANTS, INC. (If applicable) Address: 1319 NORTH SEA ROAD, SOUTHAMPTON, NY 11968 Phone: 631-283-6360 Board of Trustees App.ation GENERAL DATA Land Area (in square feet): 140,193 SQ. FT. Area Zoning: R-40 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): CONSTRUCT TWO ONE-STORY ADDITIONS TO AN EXISTING TWO-STORY, SINGLE-FAMILY DWELLING AND INSTALL A DRAINAGE SYSTEM OF DRYWELLS, ALL AS DEPICTED ON THE SITE PLAN pREPARED BY STANLEY J. ISAKSEN, JR., LAST DATED OCTOBER 16, 2006. Board of Trustees Appl tlon WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: EXPANSION OF EXISTING ONE-FAMILY DWELLING. Area of wetlands on lot: 0 square feet Percent coverage of lot: 0 % Closest distance between nearest existing structure and upland edge of wetlands: 65.6 feet Closest distance between nearest proposed edge of wetlands: 71.7 feet Does the project involve excavation or filling? XXX No Yes If yes, how much material wilt be excavated? N/A How much material will be filled? N/A cubic yards Depth of which material will be removed or deposited: ,,, N/A Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: N/A cubic yards feet 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 CONSISTS OF THE CONSTRUCTION OF TWO ONE-STORY ADDITIONS TO AN EXISTING TWO-STORY DWELLING LOCATED NO CLOSER TO THE WETLANDS THAN THE EXISTING STRUCTURAL AREAS. AS A DRAINAGE SYSTEM OF DRYWELLS WILL BE INSTALLED TO PERMANENTLY CAPTURE AND RECHARGE RUNOFF FROM THE ENTIRE DWELLING, AND A PROJECT-LIMITING FENCE AND STAKED HAYBALES WILL BE INSTALLED TEMPORARILY TO CONTAIN SITE DISTURBANCE DURING CONSTRUCTION, THERE WILL BE NO SIGNIFICANT ADVERSE IMPACTS TO THE ADJACENT WETLANDS OR TIDAL WATERS OF THE TOWN AS A RESULT OF THE PROJECT. 14-16~4 (2/87)--Text 2 PROJECT I.D. NUMBER Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART 1 -- PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1 APPLICANT/SPONSOR: [-[UGH LEE SWITZER 2. PROJECT NAME IRREVOCABLE TRUST BY EN-CONSULTANTS, INC. 3 PROJECT LOCATION: Municipality PECONIC County SUFFOLK 4 PRECISE LOCATION (Street address and mad intersections, prominent landmarks, etc, or provide map) SEQR 3180 MILL ROAD, PECONIC, TOWN OF SOUTHOLD, SCTM #,1000-67-5-1; MAP PROVIDED 5. IS PROPOSED ACT 6 DESCRIBE PROJECT BRIEFLY: ZONSTRUCT TWO ONE-STORY ADDITIONS TO AN EXISTING TWO-STORY, SINGLE-FAMILY DWELLING AND INSTAL ~, DRAINAGE SYSTEM OF DRYWELLS, ALL AS DEPICTED ON THE SITE PLAN PREPARED BY STANLEY J. ISAKSEN, JR LAST DATED OCTOBER 16, 2006. 7. AMOUNT OF LAND AFFECTED Initially 3.2 acres Ultimately 3.2 ac~es W.LL PROPOSED ACTION COMPLY ~.TH EX~STI.~ ZONm OR OTHER EX.ST~NG LA.D USE RESTRICTIONS? ~t'es [] NO If NO, describe WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residential [] Industrial [] Commemla~ Describe: ]Park Forest/Open space [] Other ] o. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] Yes [] NO If yes, lilt agency(s) and perillit/apprOvall NYS DEC LEI-IER OF NON-JIJE/SDICTION 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAL D PERMIT OR APPROVAL? ]Yes [] No If yes, list agency name and penllit/approval 12. AS A RESULT OF PROPOSED ACTION VVILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? []Y. []-o I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name R~i~,RT E. HERRMANN, COASTAL MANAGEMENT SPECIALIST DATE NOVEMBER 2, 2006 Signature: --,~[ I/'~ ~ If the action is in the Coastal Area, and you are a state agency, complete the Goastat Assessment Form before proceeding with this assessment OVER James F. King, President Jill M Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 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 POST1NG being duly sworn, depose and say: That on the ~l"day of ~ , 200(:>, I personally posted the property known as by placing the Bo~d 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 ~e date of the public hearing. Date ofhe~ing noted thereon to be held ~. ~, /~. ~- Dated: ~ ~ (si~ature) Sworn to before me this day of .2~ C200 ~. .-l~ot ar~'P~'~lic NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTBOLD In the matter of applicant:HUGHLEESWITZER~d~EVOCABLETRUST SCTM# 1 000- 67-5-1 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board cf Trustees to: CONSTRUCT TWO ONE-STORY ADDITIONS TO AN EXISTING TWO-STORY, SINGLE-FAMILY DWELLING AND INSTALL A DRAINAGE SYSTEM OF DRYWELLS, ALL AS DEPICTED ON THE SITE PLAN PREPARED BY STANLEY J. ISAKSEN, JR., LAST DATED OCTOBER 16, 2006. 2. That the property which is the subject of Environmental Review-is located adjacent to your property and is described as follows: 3180 MILL ROAD, PECONIC 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~ECEMBERI3,2006~7:~pm 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. HUGH LEE SWITZER ~dREVOCABLE TRUST OWNERS NAME: C/O HUGH S~qTZE~ TRUSTEE MAILING ADDRESS: P.O. BOX283 PECONqC, NY 11958 PHONE #: 404-266-9311 Enc.: Copy of sketch or plan showing proposal for your convenience. 5 Name: COUNTY OF SUFFOLK 2700 MILL ROAD, LLC PROOF' OF MAILING OF NOT ATTACH CERTIFIED MAIL RECEIPTS Address: SUFFOLK COUNTY CENTER 330 CENTER DRIVE RIVERHEAD, NY 11901 4651 SENTINEL VIEW ROAD ATLANTA, GA 30327 HEIDI, RONALD & STEPHEN DISTANTE HUGH LEE SWITZER IRREVOCABLE TRUST ALICIA & CHARLES THOMPSON 44 HUNTERS LANE HUNTINGTON STATION, NY 11746 4651 SENTINEL VIEW ROAD ATLANTA, GA 30327 P.O. BOX 71 PECONIC, NY 11958 GEORGE & BERNADEt'IE ALDCROFT P.O. BOX 431 PECONIC, NY 11958 STATE OF NEW YORK COUNTY OF SUFFOLK ROBERT E. HERRMANN d ol n g b u s i n e s s a t EN-CONSULTANTS, ~C 1319 NORTH SEA ROAD SOUTHAMPTON, NY 11~8 , being duly sworn, deposes and says that on the 9th day of NOVEMBER .20 06 , 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 Notices were mailed at the United States Post Office at SOUTHAMPTON that said Notices were mailed to each of (certified) ~) mail. Sworn to before me this ~th day of NOVEMBER ,20 06 Notary Public said per~y County of Suffolk Suffolk County Center 330 Center Drive Riverhead, NY 11901 Certified Fee (Endorsement Required) ResttiOted Delivery Fee (Endorsement Required) s $¢.~ 0968 Nere .~0.~ ~ George & Bemade~o Aldcro~ P.O. Box 43 I Pooonio, NY 11958 Alieia & Charles Thompson P.O. Box 71 Pegonio, NY 11958 U S E Postage 2700 Mill Road, LLC 4651 Sentinel View Road Atlanta, GA 30327 I:~ Rsturn Receipt Fee ~,~,~t,~ark ) [:3 Tot~J Po*~ ........ il/09/20~ ~ so.fro Hugh Lee Switzer ~evocable T~st ~ ~-~ 4651 Sentinel View Road ~-~ Atl~, GA 30327 111091',.."_006 Heidi, Ronald & Stephen Distante 44 Hunters Lane Huntington Station, NY 11746 AUTHORIZATION (where the applicant is not the owner) ~(4 ~%~-- (print owner of propertY) residing at ~(~-~1 C.~'~C (mailing address) / do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. · (~ner' ~ sig~ture) Board of Trustees AppOrtion County of Suffolk State of New York ~ -~Lt(,~ ~'Nt'~7-~-~- BEING D~Y SWO~ DEPOSES ~ ~F~S THAT ~/S~ IS ~ ~PLIC~T FOR ~ ~O~ DESC~ED PE~T(S) ~ ~T ~L STA~S CO~D ~ ~ TR~ TO T~ BEST OF ~S~R ~O~EDGE ~ BEL~F, ~ T~T ~L WO~ ~LL BE DO~ ~ T~ ~R SET FOR~ ~ ~S ~PLICATION ~ AS MAY BE ~PRO~D BY T~ SOUTHOLD TO~ BO~ OF TRUSSES. T~ ~PLIC~T AO~ES TO HOLD T~ TO~ OF SOU~OLD ~ ~ TO~ ~US~ES ~ESS ~ F~E ~OM ~ ~ ~L D~AGES ~ CL~S ~S~G ~ER OR BY ~T~ OF S~ PE~T(S), ~ G~. ~ CO~LET~G ~S ~PLICATION, I ~BY A~O~ ~ ~US~ES, ~ AGE~(S) OK ~P~SE~ATI~S(S), TO EN~R ONTO ~ PROPERTY TO ~SPECT ~ P~SES ~ CON~CTION ~TH ~W OF ~S ~PLICA~ON. Notary Public ~.~_ Nota~j Public, Cobb County, GA My Commission Expires August 8th, ~ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics vrohibits conflicts of interest on the ~art of town officers ~nd employees. The t~uroose of '~hi~ form is to orovide information which can alert the town ofvoss~ble conflicts of interest mtd allow it to take whatever action is necessary to avoid same. (La~ nan., fir~ nam~ middle initial, unless you are applying in the name of someone else or other entity, such a~ a company. Ifsu, iMioate the other person's or company's narn~.) NAME OF APPLICATION: (Check all that apply.) Variano~ Change of Zone Approval of plat Bxemption from plat or official map Other "Other", n me the ac vity,) Do you personally (or arough your comply, ~ou~e. sibl~g, p~ent, or child) have a ~latio~hip ~ ~y offie~ or employee of the To~ of 8outhold? "Rel~o~ip" ~eled~ by bloM, ~age, or including a p~ship, ~ ~ieh ~e to~ offi~r or ~loy~ h~ eyre a p~fl o~e~hip of(or emplo~ant by) a eo~oration in which the to~ offie~ or ~ploy~ o~ more ~ YES NO If you answered "YE", complete the balance of this form and date and sign where indicated. Name of person employed by the Town ofgoutho!d Title or position of that per,on Describe thc relationship between yourself(the applicant/agent/repre~antafive) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the apace provided. The town officer or employee or his or her spouse, sibling, parent, or child is (cheek all that apply): A) the owner of getter than 5% of the share~ of the corporate stock of tho appl/eant (when the applicant is a corporation); B) the legal or banefic~l owner of any interest in a non-enrporate entity (when the applicant is not a co~oration); C) en oflieer, director, pax-mcr, or employee of the al?licant; or __,D) thc actual applicant. DESCRIPTION OF RELATIONSHIP f of 2oo_4 EN-CONSULTANTS, INC. 1319 Nodh Sea Road Southamp~n, New York 11968 631-283-6360 Fax: 631-283-6136 www. enconsultants.com ENVIRONMENTAL CONSULTING November 6, 2006 Town of Southold Board of Trustees 54375 Main Road Post Office Box 1179 Southold, New York 11971 Attn.: Lauren Standish Hugh Lee Switzer Irrevocable Trust 3180 Mill Road, Peconic SCTM #1000-67-5-1 Dear Ms. Standish: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: Three (3) Wetland Permit Applications including a) Short Environmental Assessment Form; b) Authorization & Disclosure Forms; and c) Surveys. Three (3) LW-RP Consistency Assessment Forms including a) Surveys. One (1) set of site photographs. Application fee of $250.00 wetlands. 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. SRo~iIy' ~. Herrmann ~ Coastal Management Specialist /khs Enc. .68' DELINEATED BY EN-CONSULTANTS, N INC., 8-23-06 . S 62'23'00"W N/F 2700 MILL ROAD LLC :S 27'22'50"E 30.27' S 49'07'59"E ~9,76' 50"41 38.13' S 22'06'22"W 54.01 ' DESCRIBED PROPERTY APPROVED BY BOARD OF TP, USTEE3 TOWN OF $OUTHOLD DATE /.,/~,/~ ? PECONIC, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SURVEYED FOR: HUGH KENT SWITZER UARANTEED TO, HUGH RENT SWffZER NOTES, NOV 1 3 200~ TOP OF DOGHOUSE (SAME SIDE ON ROOF SURVEYED BY STANLEY J. ISAKSEN, dR P.O, BOX 294 NEW SUFFOLK, N.Y. 11,~56