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Home My WebLink AboutTR-4158E,SOUTHOLD TRUST ISsued ToL' ~ '~ ' t Date-J4~~ Address ,s'~ . THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION TOWN TRUSTEES OFFICE,TOWN OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL,: 765-1892 Board Of Southold Town Trustees. SOUTHOLD, NEW YORK PERMIT NO .... 415S DATE: ..Ma,¥ 20o. lC).93 ISSUED TO ............ ,.-V,[CHAE~...GA MBARDELLA ........................... Authorization Pursuant to the provisions of Chapter 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 South°Id Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS tN 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 Resolution of The Board adopted at a meeting held on .5./29./93..i.. 19 .93, and in consideration of the sum of $ !,.~.5~,00. paid by Enzconsnltants. £oz...Micb~el. Gambardella of ......... C.u~.cko.g~te N.Y. and s"biect to the Terms and Cond;t;ons listed on the reverse side hereof, of Soufheld Town Trustees authorizes and permits the follawincj: To constru.ct a timber dock consisting of a 4t X 110~ fixed elev. wMk (incl. ramp at inner end), a 4~ X 12~ hinged ramp, & (2) 8t X 16~ floats secured by (2) 2 pile dolphins. Haywaters Co~e. all in accor~dance with the detailed specifications as presented in the oricjinatincj application. IN WITNESS WHEREOf:, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these p.resents to be subscribed bY a majority of the said Board as of th~s date. t I HOG NECK / / / ! 4 IrN"CONStF, L?ANi~. NORTH 1,4AP OF PI~OPEP. TV BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall Annex 54375 Ma/n Road P.O. Box 1179 Southold, New York 11971-0959 TelephOne (63~ 7~-1~2 ~ NOV 2 6 2012 HURRICANE SANDY EMERGENCY APPLICATION Valid thru June 1, 2013 Suffolk Counw Tax Map Number: Agent (if applicable) Address: Phone Number{s): Board of Trustee Permit Number{s):. L.{ l '~' g Will any pail of this project require a Building Permit? How much fill will be required? ILS County of Suffolk State of New York ~.~/'/~/~b/~ ~/A'(I"/3/,4/~' I~ ~/~C/~ 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 1N 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 IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature of Property Owner SWORN TO BEFORE ME THIS ~¢-~ DAY OF J~k.K'~/'~J,~-~ ,20 Ic~ Notary Public CONNIE D. BUNCH Nota,W Public State of New York No. 01BU618,_0~.,-, OuaD'ied Suffolk AUTHORIZATION (where the applicant is not the owner) I, residing at (print owner of property) (mailing address) do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner's signature)