HomeMy WebLinkAboutTR-5rev. 3/28/88
YOUR ORIGINAL PEP=HIT NUMBER
BOARD OF TOWN TRUSTEES
Town of Southold
Ma,:n Road
Southold, New York 11971
APPLICATION FOR SPECIAL !CE DAMAGE PERk4!T
INSTRUCTIONS: Fill out form below and return to above address. You
should have this application approved and returned to you within a week°
1. Applicant s ame & Address:
2. Contractor's Names & Address: ~D%.~on-7 ~.
3'. The purpose of this application: Redr±v±ng or replacing openwork
dock or openwork pier piling, and mooring piles, removal of damaged
piling, repair, resetting or replacement of floating docks, ramps,
or decking, all necessitated by ice and storm damage resulting during
1987-1988 winter.
SPECIAL CONDITIONS
1. No dredging or filling is permitted.
2. Repairs to. existing structures shall be limited to replacement of
timbers without change in design or dimension.
3. No repair or replacement of bulkheads is permitted under this permit.
4. No freshwater or tida~ wetlands are to be disturbed under any
circumstances. '~:~
.~5. A yellow permit sign provided by this office shall be displayed on
the pro~ect at all times while under replacement.
6. Original permit numbers (3 '~ hi~h)~:~ust be permantl~ displayed on
project.
(Tear off and return)
'I, , certify that the work ab authorized in
this permit has been completed and is now ready for your inspection.
Also, the permit number requir~d on this project is clearly visible.
PERMIT NU~IBER . ~