HomeMy WebLinkAboutTR-128-6-2 Board Of SOuthold 'Town Trustees.
SOUTHOLD, NEW YORK
Pursuan+ fo +he provisions of Chapter 615 of fhe Laws of
+~e State of New York, IB93; and ~ap+er 404 of fha Laws of the
State of New York 1952; and +he SoufhoJd Town Ordinance eh-
filled "REGULATIN~ AND THE PLACIN~ OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS end the
REMOVAL O~ SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and in accordance with
Resolution of The Board adopted afa meeting held on ~.~8
J9 ~..~, and in consideration of tho sum of S ,',,;,"~':i paid by ..,,
· . of N.Y. and subject fo fha
' "orms and Conditions llsfed on fha reverse side hereof,
au+normzos p ~ '
, of Sou+hold Town Trustees ' ' and ermifs tho roll
- owing:
~JJ Jn accor~dnce w~fh fha defa~Jed spoci~ca+~ons ds presented in
t,: 'the originating application.
IN WITNESS WHEREOF, The said Board of T'usfeos here- ..~
by causes ifs ~orporafe Seal fo bo affixed, and +hose presents ~o
'" be subscribed by e m~[or~fy of fhe'~a~d Board as of f~is date.
TRUSTEES SCOTt L. HARRIS
John M. Bredemeyer. BI. Presidem Supervisor
Henry P. Smith, Vice Presidem Town Hall, 53095 Main Road
Albert J. Kmpski, Jr. P.O. Box 1179
John L. Bednoski. Jr. Southold. New York 11971
John B. Tuthill BOARD OF TOWN TRUSTEES Fax (516) 765-1823
Telephone t516~ 765-1892 TOWN OF SOUTHOLD Telephone (516) 765-1800
GRANDFATHER APPLICATION
t. Name of Applicant: /gU~YS'7-U$' D. ~'}~ SE,V
2. Mailing address: D~ ~O~~ /~/7~7-/~'~JCAJ /~Y /1~
3. Address of Property: 27f0
Tax Map N~er: 100O- /~ ~-~ Approx.yr.o~ construct: /~
5. Prior owner if known: ~E~LF ~ ~LL
6. Diagr~ of existing structures, including all d~ensions, must be
included with this application:
7. Indicate on attached map: Location, ie; reference point, telephone
pole number, adjacent property owners, etc.
Signature of applicant: Date:
* Please note, there is a e of $50.0~ for filing this
application.
I
~t~on of w~er I I ~e 17. ~ 7. 8:;"
SPOES I, , ,l' H~s W~ M~ageme~
~ A~cle 15. T~e 15: ~ A~a 19:.
A~e
34:
Water Sup~y I , I Nr P~l~an Canal
~ ~en M~gement
-- A~ie 15, ~e 15: ~ ~e ~, ~e E: ~ A~e 38: .
~~ 15,~ 15: ~ ~e 24: ~ A~ 1, 3, 17. 19. 27. 37; Long l~nd ~ ~h~r We~ 6NY~R 380: ~on
~e 15, T~e ~:
~e
25:
V~ld, S~flic ~d Recma~onal
~em ~ ~e 27, ~Ue 7; 6NYCRR 360:
I I
~lid Wa~e M~agem~t
~ 6NYCRR 608:
Wa~ Q~ Ceffifi~fion
CONTA~ PER~N ~R PE~I~WORK
Const~ct ~ 18" of existin~ [~ctio~l bul~ead //~ linear feet of bu~ead
md plant--cu, yds. of backfill. .~/~ O ~)~ (T S /~ t t /3
By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance
with the ECL, all applicable regulatians, the General Conditions specified (See Reverse Side) and any Special
~e~ition~ included as part of this permit.
aaa,
~EMtT AOMINI~TI{ATO[{ .~OR~$$ Regulato~ry Affairs, Region One, Bldg. 40 SBNY
Robert Ao Greene J Stony B~pgk, ~.Y. ! 1790'-2356