HomeMy WebLinkAboutTR-1044PERMIT NO:
ISSUED TO .
Of $outhold Town Trustees
SOUTHOLD, NEW YORK
]_044 DATE:
Pursuanf fo fl~e provisions of Ghapf,er 615 of fhe La~s
f~e'Sfafe o~ NeW YOrk, ]893; and C~apfer 404 o~ ~he Laws o{ fee
New York 1952;,,and fhe :Soufhold Town Ordinance en-
ffflea "REGULATING AND THE PLAClN~ OF OBSTRUCTIONS
IN AND .ON TOWN WATERS AND PUBLIC LANDS a.~
,REMOVAL OF SAND ~RAVEL OR OTHER MATERIALS FROM'
'LANDS UNDER TO~N WATERS;" aha in accordance wi~
Resoluf[on of The BOard adopfed ara meeting held on Sept. ~'~lO
19..].~.:., and in Considera+bn of.the sum of $~.].:.20 paid
of' :..~.~A~ ~A~9.~....g~.,..~.....~.~.e.~p~. Y. and subjecf f~ fha.
~":~Te'rms and Condffi°~s listed' '°n +h'e reverse s]de ,
of Soufhold ToWn 'Trusfees'aUfhorizes and permffs fha foi[owlng
IN WITNESS WHEREOF, The said Board of Trusfees here-
by causes its Corporafe Seal to be affixed, and +hese presenfs to
be subscribed by a maiorlty °f'fhe said Board as Of
Trustees
Telephone
516 - 765-3783
August 5, 1975
James H. Rambo, inc.
Bishops Lane
Southampton, N.Y.
Attention: Tom Samuels
Dear Mr. Samuels:
Please be advised that the following resolution was passed
by the Southold Town Trustees at their regular meeting held
on August 4, 1'975:
"IT WAS RESOLVED that the Southold Town Trustees grant a
one (1) year extension of time ko Dr. Maxwell Y. Simkin
on Permit # 1044. Subject permit extended until September
10, 1976".
cc:file
Very truly yours,
Bett~ N~v~ary
Board of Southold Town Trustees
BOARD OF TOWN TRUSTEES
Town Of S0uthold
Southold, New York 11971
Main Road
Rev. 6/72
APPLICATION FOR A BULKHEAD, DIKE, OR JETTY
1. Does this p~jeft involve the use of WETLANDS as defined in the Southold Town Wetlands
Ordinance?~ or NO. If it dbes, you must file through the Town Clerk's Office.
2. Is the proposed work entirely wifh,i~the boundaries of your own property as substantiated
by your Deed or Survey? YES or~NC~) If it is, a P. er. mit.is.. NOT required from this Board,
but the Town Building Inspector sh~ld be contacted tor tull details.
.............. L./..T ............ ~...'...:. ........................... ;...~ ................................................... '/' .......... :~ .................
4. Contractor's. name and address: ............ ~. ........................................................................................
5. Explain briefly the purpose of this application: ~'~'~"~ ~>,:' ' ~ ....... ' ...... :~:;
......................................... ~ ' ~ ~ ~.) I ~ 2 :>* ~':% ~
-. . ,. . ~ :-: .... r ............. ~ ....... : ............................................................................................................................ ~
6. After issuance of Permit, I exper to: (mark with a.n X)
(o) Commence work AT ONCE ............; ASAP ............ ; U~KNOWN TIME ~
(b) Complete work in -- 1 DAY ............ ; ] MO ............. ; 1 YR ............. ; FUTURE .............
7. Secure the correct Area Msp from the Secret~ o{ this Board, ond by usin~ on X WITHIN
A CIRCk[ ~s o mark, indic,re ~s closely as possible the I~¢io~ of this pro~ect. On tho
reverse side, provide ~ SCAk[ D~WING which will show Ordin~ Hi0h Wotor M~rk as well
as the size ond shope of tho structure or work to be done. Also indudo oll dimensions {or
portions which extend offs'bore from the O. H. W. M.
8. Provide the following documen,ts:
(al A Licensed Engineer's Survey of the property involved.
(b) A copy of the Contractor's Plan and Specifications.
9. Does this project extend into Town Waters beyond a,n imaginary line oj~oundary formed
by existing works of a similar nature along this area's shoreline? YES or~ If it does, state
the approximate distance beyond, . ........... ft.
10. Will this construction require ~he Filling of any land offshore of the O. rdinar~H~gh Water
Mark or the Dredging of 'any material from Town Lands un~er water? YES o~NO~J If it does,
Form A/4 (Application for Dredging/Filling) must be completed and attached a~a'rt of this
application.
] ~. In requesting approval of fhis application, I submit thor: the information presented herein
is true and correct to the best of my knowledge and belief; I am the person accountable for
the performance of the work in accordance with fhe plans and specifications attached; I haYe
read or am familiar with the provisions of any Southold Town Ordinance pertinent to the work
involved; and further, I intend to adhere to and abide by the Terms and Conditions of the
Permit, when a,nd if issued to me.
Accepted by:
,!
..................
SECTION 726~ OF THE NEW
EDUCATION LAW.
COFJES O¢ THIS SURVEY
iD ~DD,ItCNAL ~NS~J~UIiONS