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TR-1526
ALL DOCKS AND BULF~qEADS MUST D IS PLAY VIS IBLE PERMIT NUMBERS Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO ......... :~.;~.6 ............. DATE: .~]~.r ....]~.:......]-982 ISSUED TO ................... q~.S...t. ~...v..e......~9.~.~.m...a..~ ................................................................ Pursuant to the provisions of Chapt.er 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance en- titled "REGULATIN~ AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF 5AND, GRAVEL OR OTHER MATERIALS FROM LAND5 UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted at a meeting held on 19..7~ .... and ~n consideration mc the sum of $.. 3~2..:..~.? ...... paid by Gustave Weidman of ................. .~.~?.~.~.C_. ............................................... N. Y. and subiect to the Terms and Conditions listed on the reverse side hereof, of Soufhold Town Trustees authorizes and permits the following: to construct a catwalk, ramp and floating dock at Richmond's Creek, Peconic. all in accordance with the detailed speciflcafions as presented in the orlg[nating application. IN WITNESS WHEREOF, The said Board of Trustees kere- by causes ifs Corporate Seal fo be affixed, and these presents fo be subscribed by a majority of the/~aid Board as of?this daf, e. ......... ...... ................ ...... ................. / Trustees TERMS end C:ONDITIONS The Permittee Gus tave We idman residing at Wells Avenue., Peconic N. ¥., as part of the consideration for the issuance of the Permit does understand and prescribe to the fol- lowing: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or rialtos for damages, of suits arising directly or indirectly as a result of any oper- ation performed pursuant to this permit, and the said Permit, tee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes ~ liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold 2. That this Permit is valid for a period of 12 mos. wMch is considered to be the estimated time required to complete the work involved, but should circumstances waxranr~ request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permimm wishes to maintain the structure or project involved, to provide evidence to anyone concerned that anth- orization was originally obtained. 4. 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. 5. That there will be no unreasonable interference with'navigation as a result of the work herein audiorized. 6. 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. 7. 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 obsrrucnon to free navigation, the said Permittee will be requited, upon due notice, to remove or alter this work or project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee or the completion of the work auth- orized. 9. That the Permittee will obtain all other permks and coments .that may be required plemental to this permit which may be subject to revoke upon failure to obtain same. BOARD OF TOWN TRUSTEES Town of Southold Ma;m Road Southold, New York 11971 PI1 Rev/6/72 To: Gustave Weidman 1. Your application, dated ..... Ap.r.i.l..ll.,...~kg7.7. ................................. has been reviewed by ,Chis Board, at a mee''cing of the Trustees held on .... ..M..a.y......3..,.....1..9...7..7. .............................................................. and resulting in the action, as indicated below: ( ..... .x. ..... ) ( ............ ) ( ............ ) Application approved. Application denied. Application tabled. Commen~ and remarks: You will be required to get a permit from the Army Corps of Engineers. Contact Mr. Jose Almodovar at 727-4257 for application form and assistance in completing same. You ]must also have a permit from the Dept. of Environmental Conservation, Building 40, SUC, Stony Brook, New York. 3. If your application is approved above, A Permit Fee is now due, and should be mode payable to the order of the Board of Southold Town Trustees. This fee is computed below according to ?he Schedule of Rates as set forth in the Instruction Sheet (Form I/1). If the Permit Fee is paid in person to the Secretary of the Board, The Permit will be ob?ainable at the same time. If the fee is paid by mail, the permit will be mailed in reply. Computation of Permit Fee: Ramp 3'x12' - 36 s.f. Float 6'x20' -120 s.f. 156 s.f. @ .10 = $15.60 2 piles @ $1.00 2.00 $17.60 Less paid on application 5.00 DUE ~12.60 Total Fee for this application ............................................................ $ .... 1.7..:..6..0.. ....................... Signed ..... AL.V. Aid..B. ,....GO Y~I~D-~ l.T. tf ................... Chin. Board of Southold Town Trustees. Sec reto ry. /' Rev. 6/72 BOARD OF TOWN TRUSTEES Town Of Southold Main Road Southold, New York 11971 APPLICATION FOR FIXED and/or FLOATING DOCKS Applicant's name and address: ...... ~...." '~'.'~ ....................................... .......... ..... ............................. , ................... . ............................ .................................................... 4. After issuance of a Permit, I expect to: (mark by an X~) (a) Commence work -- AZ ONCE ............ ; ASAP t~""~, UNKNOWN (b) Complete work in -- 1 DAY ............ ; 1 M© ............. ; 1 YR ............. ; FUTURE ............. 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, t~he 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 '1'own Waters beyond an imagip~q~ line or boun,dary formed by other similar structures along the area's shoreline? YES_os(NO. ) If it does: extend beyond this so-called dock line indicate by how fair, approximately,..~..'"ffTT~' o Provide the following documents: (a) A Licensed Engineer's. 'Survey of the property involved. (b) A copy of the Contractor's Plans and Specifications. Will this construction require the Filling of any land .offshore of the Ordin~gh Water Mark or the Dredging of any material from Town ka,nds, under water? YES 9f NO. ]f it does, Form Al4 (Application for Dredging/Filling) must be completed and attachea'~l~rt of this application. 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. .Accepted Dated: RO~D