HomeMy WebLinkAboutTR-5847ESOUTHOLD T'RUST
Issued To~ Date~
Address -~ ~ .
THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION
TOWN TRUSTEES OFFICE,TOWN' OF SOUTHOLD
SOUTHOLD, N.Y. 11971
TEL.: 765-1892
Board Of $outhold Town Trustees
SOUTHOLD, NEW YORK
Pursua~ lo fl~e pe'ovislons of Ghepter 615 of fl~e L~ws of
~he Slafe of New Yod~ 1893z end G~apfec ,104 of ~e L~ws of ~e
Sfe~e of New Yod~ 19~Z~ and ~ So~fi~d To~ Ord~ee
tilled ."REGULATING AND THE PLACING OF OBSll~.~
IN AND ON TOWN WATERS AND PUBLIC LANDS emi
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROid
LANDS UNDER TOWN WATERS;I,'. end in ~:~.,orde.ce with ~e
Resolution of ~ B~erd adopfed af · meeting Iteld on .,...D..~.~;.~...~.7_...
2(~..., end let ¢omlderafion of fhe sum of $..~0_.,.~.0 .... pe|d by
of ..... $°u.~0~d. .......................... N. ¥. end ,,bjeeS fo ~e
Terms end Concl'dions listed on ~e reverse dde
of Sou~old Town Tn~mes eu~h~'izes end pem~s fhe
ell in acem'dem:e wi~ ~he detailed spectfic~fiem ~s prm, on~ed
she orlginaflng application.
IN WITNESS WHEREOF, The said Board of Trudees hem-
by causes ifs Corporate. Seal to be afl'amd, and these..~e~, ._ to
be subscribed .by a malodfy of tim said Board as of .~is deb.
P.3
BOARD OF TRUSTEES APPLICATION
AUTHORIZATION
(where applicant is not the owner)
I. ,~M~~residing at ~
(p~n~'owner of property) (mailing address)
$~,-~Lg.~0~ ~JY: I~i71 do hereby authorize J.M.O. Environmental
(agent)
Consulting to apply for permit(s) from the Southold Board of Town
Trustees on my behalf.
O~dd~'
Quogue, New York
SECTION
Pt~p lOX Is D~C~
Applicam: George Kaytis
Locatiom 3740 parad~ Poim Road
Datum: Appa~em Low Water
S~C.T.MNo. 1000-$ t -3-28
purpose: Reconstruction of existing faclii~.'
~;LGCAT~D
SCAL~ ~2~
Applie~ prop~e~ to
with~ 18", 125' of timber
bulkhead, u~ ~-consu,uet au
existing 2' x t 5' stairway, to
relocate an 8'x I4'6" deck and
shed to 1~_;:: :r~ of butkhead,
to consm,~ .. ~ x4' landing, to
construct a 4' x 8'6" st~'way
and consmact a 10' x 15' deck
land~-ard oYlh~ bultCqead. A~
Shelter Island Sound, Southold,
Town of Sou~old. Suffolk
Cotmly, New York.
J.M.O. Environmental Cousulting
RO. Box 44V
Quogue, N,Y, { 1959-0447
5TAIP, S
Apl
within 18", 125'
bul~.:head, to recollslll, lct aq
existin~ 2' x I S' stairway, lo
relocate an R'x 14'6" deck
shed 1o landward of b~dkheml,
to cm~stmct a 4~ x4' Im~ding, to
conslmc/a 4' x 8'6"
and c~stmct a I0' x I ~' dec~
landward ofthe bulkheed. A~
Shelter Islsnd Sound,
Towl~ of Southold,
Couwty, New ~.
[~'J.M.o. ~nwronmental Consulilng ,mrvice$
Quogue, New
SURVEY FOR
GEORGE El ~IAIVE K~YTI$
TROPICAL STORM SANDY EMERGENCY APPLICATION
Valid thru June 1, 2013
Property Owner Name: ~£
Permanent Mailing Address:
Phone Number(s):
Property Address:
Suffolk County Tax Map Number: 1000 -
Agent (if applicable)
Address:
Phone Number(s):
Board of Trustee Permit Number(s): /~ ~ ~
Will any part of this project require a Building Permit?
How much fill will be required? / ~) ~ \/A- ~/~
Project Description: /~ ~~ / ~ ,~
County of Suffolk
State of New York
BEING DULY SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE
TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK
WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY
BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT
AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES
HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING
UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS
APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR
REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES 1N CONJUNCTION WITH REVIEW OF THIS APPLICATION.
Signature of Property.O(vner
AUTHORIZATION
(where the applicant is not the owner)
(print owner of property)
residing at
(mailing address)
do hereby authorize
(Agent)
to apply for permit(s) from the
Southold Board of Town Trustees on my behalf.
(Owner's signature)