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Home My WebLink AboutTR-925 icFmt T� _-� -M`�---�5"�"" �-.=x"€``: " ..1'1` - .n-.- '"` c�" > ..�•- M`f �_ � b �',�..';^ Ida` �i�� +Fw ��`�rq� q ,!N'..i ` "d+�.'MPv -y•$�'�' 1 rya �•� 2n C��v,,M1 ,' - i'3- `:�7n.^t"` '�+t•_'s�'�a$�� 'n. '.'i�`��£`�� ^_�y`�w,.� �YY:r��.se+c�C�'� _ �r.''a-�' -,. Board Of Southold Town Trustees ?<,: ' _ SOUTHOLD, NEW YORK PERMIT NO. 925 DATc. May 7 , 1973 " r Y ISSUED TO . . . .. .. Carlos. .Tejo r' a Pursuar.= to the provisions of Chapter 615 of the Laws of 'rhe Srate of New York, 1893; and Chapter 404 of the Laws of the trete of New York 1952; and the Southold Tewn Ordinance en- +7 n- t tied "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the Resolut;on of The Board adopted at a :nee,-ing haid on May 7 1973 and ir. consideration of the sum of $ 13 .0.=' paid by Carlos Tejo of .Maple Lane, Mattituck , N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, ct Southold Town Trustees authorizes and permits 'rhe foilowing Construct an open dock, "L" shaped, 1(;0 ft. bJ ? f._. (50 ft. by 2 ft. cf which is on his own rropeity) , and 15 £t. by 2 ft. , from the edge o? t:e uplan:l on his pproper t.; to the 'onG C-,=_ek branch of xattituc: ^leek, Madttitu-v ,t Ne�rjX�drk, au [n acwr ante wi he e,ai a specifications as presented in 'he criginaing application. IN WITN5c'55 WHEREOF, The aaid Board of IruSTees here- by causes its Corporate Seal to be affixed, and These presents to be subscribed by a majority of the said Board as of this date. � :• T stees R Rik _ n4�y ° `� +� '4w W . t '9 �� 9kY nr r� r y. M, it'd a 7 -.Y r di V °aw J,Y �`'S 7 r`➢;)aPIT7 ,•awa.r^ d� 3 --!' t y�3--+A`?3'e^✓ ^.i. aRK'w 'j-� .ia.,� '+ - r .. .,,`-s"i' -, Mnes''`. -t°` •.t.,`Ai TERMS and CONDITIONS The Permittee Carlos Tejo j residing at Maple Lane . Mattituck N. Y., as part of theconsideration for the issuance of the Permit doer understand and presm'be to the fol- lowing: 1. That the said Board of Trustees and th_ Town nf Southold are released from any and - all damages, or claims for damages, of suits arising d;xecJy or indirectly as a result of any oper- rg anion performed pursuant to this permit, and the said Permittee will, at his or her own empense, defend .gay and all such suits inivated by thi.-d patries, and the said Permittee assumes full !lability p with respect thereto, to the complete exclusion of rhe Board of Trustees of the Town of Southold 2. That this Permit is vaiid for a period of 12 mos, which is considered to be the F? estimated time required to complete the work involved, but should rircumstances warrant, request for in exrension may be made to the Board at a later date. - .a� .. Timr chis Permit should be retained inde-Hni:e!y, or as !ong as sire said Penni-tee wishes to maintain the structure or project involved, co provide evidcnee to anyone concerned that auth- oruation was originally obtained v. Thar rhe work involved will be subject to -the irspecticn and approval of the Board or its agents. and non-compliaoce with the provisions of the originatirq application, may be cause for :. revocation of this Permit by rzzolution of the said Board. �E i - Thar .-here will be no urreasomhie interference with or_vtgation as a �r:At of -he work it herein aud�or:zed. r G. That rhe.e shall be no interference with the right of the �ntbdc ro pass and repass along the beach berween high and low water marks, ' 7i G •ai �. That f future operations of the Tow-2 of Southold rL-quire •.i::. :c-.cowal and/or alterations G 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 or project herein stated without eapensei to the Town of Southold S. Thar the said Board will be notified by the Permittee of the completion of the work auth- orized. 9. That the Permittee will obtain all other permits and consents that may be requited sup- plemental to this permit which may be subject to revoke upon failure to obtain same. �I zrl�vs k,/ Z /A LO (OL:0( 54f ylk, o \� Ir ul qu At Ae ;� �. u' a H HJ1Mif O o I I T ~ 3N c N any 11 cam/ vim�\ \ � .. r,\ I ' '!-� /l': ' • ' �T� � n.� ^ f--� �F !! --__.t•. 11 L Rev 6 77. BOARD (W TONG N TRUSTEES Town of Southold Alain Road Southold. Ne« York 114 1 Maple Lane To. Carlos Tejo, M.D. , Mattituck , New York 11952 . ............................... .......................... .......................................... ..................... ... . . .. . 1. Your appCcotion, dated ............Ma.r.c.. .... h 15. .......19.. 7..3.. ...... .. .. .... .. has been reviewed by ti . .. . . . ... . Board, at a meeting of the Trustees held on ... ...M?.Y...7.,... 1.9.7.3.............................. . . .. ..... . ....... and resulting in the action, as indicated below: Application approved. (............) Application denied. (............) Application tabled. 2. Comments and remarks: 3 If your application is approved above, A Permit Fee is now due, and should be mc-le po�nb e io tho order of the Board of Southold Town Trustees. This fee is computed below acc3rdinn rc .the Schedule of Rates as set forth in the Instruction Sheet (Form 1/1). If the Permit Fee is paid in person to the Secretor, of the Board, The Permit will be obiainoolc at the some time. If the fee is paid by mail, the permit will be mailed in reply. Computation of Permit Fee: "L" Shaped dock : 50 ft. by 2 ft. R lOC sq. ft. = $ 10 . 00 15 ft. by 2 ft. a 10C sq. ft. = 3 . 00 $ 13 . 00 TOTAL FEE — 5 . 00 FILING FEE P; $ 5. 00 DUE Total Fee for this application ............................................................ S ...8.'. o Vul'1'...... Signed ......`lvah B. Goldst ith ........... ............ .. Chr Bc.-rd c Sou-';o4i -,,i Tr-^;te;: Secretary. P t Ree 6 5. 110,1RD OF TOWN TRUSTEES Town of Southold Main Road Southold. Nee. Fork 11971 To: Carlos Te 'o, M.D. , Ma Le Lane, Mattituck, New York LLS+`i2 ...................... ............ .............. .................................................................. ......... . .. .. I Your application, dated .................March...15,,,,,, 9,7,3,,,,,,.,,....,.,,..., has been reviewed by ti,is Board, at a meeting of the Trustees held on .........ApY i.1..2,....19.73......................... . .... .. ..... . ... and resulting in the action, as indicated below: (............1 Application approved. (............) Application denied. (...XX....) Application tabled. — BOARD WILL INVESTIGATE THE SITE. 2. Comments and remarks: If your application is approved above, A Permit Fee is now due, and should be rrjde payU': to tb order of the Board of Southold Town Trustees. This fee is computed below o--cording ..he Schedule of Rates as set forth in the In;tructien Sheet (Form 1/1). If the Permit Fee is paid in person to the Secretary of the Board, The Permit will be obiamj-i; at the same time. If the fee is paid by mail, the permit will be mailed in reply. Computation of Permit Fee: Total Fee for this application ............................................................ $ ................................. . ... Signed ALVAH B. GOLDSMITH ................................. Chm. Board of Southold Tcwn Trustee_ b i •- . Secretary. < wia - Rev. 6/22 BOARD OF TOWN TRUSTEES Town Of Southold Main Road Southold, New York 11971 APPLICATION FOR FIXED and/or FLOATING DOCKS 1. Applicant's name and address: ...........(;FI.R,l o S i r :T J ., /l? Tt 1 '�.1�.�.r.Z.E.......`.! Y . . } .:.�.:....:.•... .. .............. .......................... ... •,.. .. r 2. Contractor's name and address: ................:...........................................e.......-:....._.......................... 77 .. -...... !::•...... ...r.��:l�.��...........zSG.L�..,....h..., .......:'..:.5- ...c................................... 3. Briefly explain the purpose of . .e ....�c�k this a/spplication: ....................................�........................,.. ...... ............... ... . . ............. k v ..... ... A.... � . r ................................................................................................................................................................. 4. After issuance of a Permit, I expect to: (mark by an X9 (a) Commence work — AT ONCE ....x....; ASAP ............: UNKNOWN ............. (b) Complete work in — 1 DAY .....?�..; 1 MO. ............: 1 YR. ............; FUTURE ............. 5. Secure the correct Area Map from the Secretary of this Board, and by using an X WITHIN A CIRCLE indicate as closely as possible the location of this dock. On the reverse side of this map, provide a SCALE DRAWING which will show Ordinary High Water Mark, the shape and size of the dock and any supplemental pilings which are needed to hold a floating dock or tie-up a boat. Give all dimensions necessary to determine the area of the dock surface which extends offshore from the O. H. W. M. 6. Will any portion of this construction extend offshore into Town Waters beyond an imaginary line or boundary formed by other similar structures along the area's shoreline? YES or NO. If it does extend beyond this so-called dock line indicate by how for, approximately...........ft. 7. Provide the following documents: (a) A Licensed Engineer's Survey of the property involved. (b) A copy of the Contractor's Plans and Specifications. 8. Will this construction require the Filling of any land offshore of the cry High Water Mark or the Dredging of any material from Town Lands under water?I YES r NO. If it does, Form A/4 (Application for Dredging/Filling) must be completed and attaced as part of this application. 9. In requesting approval of this application, I submit that: 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 the plans and specifications attached; I have 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 and if issued to me. / . .. r ........................�............ AccjWed by: Dated: