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Home My WebLink AboutTR-1257Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO ................ ~-.2~7. DATE: ... ISSUED TO John, Fife .................. ............................... Pursu~n~' ~'o the provisions of Chap,'er 61B of ~he L~w~ the Stale of New York, 1893; and C.hap~er ~ of ~he Laws of ~he S~a~e of New Yo~k 1952; and fhe Sou~hold Town Ordinance flfled "REGU~TIN~ AND THE P~CIN~ OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and ~he .REMOVAL OF SAND, ~VEL OR OTHER MATERIALS FROM DS UNDER TOWN WATERS;" end in accordance with ~he Resolution of The Board adopted ~ ~ meeting held on : 19..~.:.., and in con~d~rafion of ~he sum of $__...~Q.~.QQ_. paid by /.~ ............ ~o~ .~ .............. ~ ................................................................ Terms '~nd C0ndlflons' llsfed on ~he reverse side hereof, of Soufhold To~n Trusf~s eu~horlzes and permits the following: (5. x 20) ~ ~ ~gs ~ ~o~ o~ ~e~y ~11 in accordance wi~h th~ d~fai~d specifications as pre~nfed Shs or~glnafhg appllcaf~on. IN WITNESS WHEREOF, The s~d Board of T~s~ees kere- by causes i~s Corp0ra~e S~al fo be aff?~d, and ~hese presents be subscribed by a majority of the sa~a Boara ~s of ~hls ~et, e. BOARD OF TOWN TRUSTEES Town o£ Southold Main Road Southold, New York ]1971 ~'l! Re¥/61 To: John Fife 1. Your applioatJon, doted ..... ~...~]~lJ~r...1.,...~,c~...7- .................................. has been reviewed by t~is Board, at a meeting of the Trustees held'on ...,.~.~.~....,~.,~,,.....~.?..?..7. .......................................................... o,nd resulting in the action, as indicated below: (.oo.~...) Application opproved~ ( ............ ) Application denied, ( ............ ) Application tabled. 2o Comments and remarks: Also needs approval from the U. S. Army Corps of Engineers end the Department of Environmental Conservation of N. Y. 3. If your application is approved above, A Permit Fee is now due, and should be made payable to the order of the Board of Southold Town Trustees. This fee is computed below according to the 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 obtainable at the same time. If the fee is paid by mail, the permit will be mailed in reply. Computation of Permit Fee: x 20 walkway 100 sq.ft.@olO = $10o00 x 20 floating dock 160 sqoft,@°10 = 16.00 pilings @$1.00 ~o00 total fee $30.00 paid 5.0~ Due $25.00 Total Fee for this application ............................................................ $ ....... .................... Signed .... ,~...L, .V. ~....~..*...,q.O., .L..D. ~..M..I..~. .................... Chm. Board of Southold Town Trustees. by : ......... ' ....... A/2 - Rev. 0/'/2 BOARD OF TOWN TRUSTEES Town Of Southold Main Road Southold, New York 11971 APPLICATION FOR FI~k'~ and 'or FLOATING DOCKS 1 Applicant's name and address: ....... ,?.. ..~ ....... ~.. ..~'......~, ........ ~.t...~I..~ ....... .~..~ .... ....C...~..~..~...~.~.~. .......................................................................................................................... 2. Contractor's name and address: ............. ..L~.* .............. .~.~}.~.~.~ ........................................................................................... 3 Briefly explain the pur~se of this application: ..Z~ ....... ~.~.~.~......~....~,:.~.~ .Z~ ....... ~.f~.~.~ ...... ~..~.&.~.L ~.....:~.~ ....... ~..~.~.~ ....... ~:.~.~ ....... .~.~4 .......... ,.h~ ........ ~......~.~.~.~.~ ....... ~..~..~A ........ ~.~. ...... ~..~.~J~. ...... L~.)..~J.....~..~ .... ...~..u..~......~.,~.~h.....~..~.~ ........ ~.,~s....,~.~.s..~.....~..L~}~.....i.~.~ ...... ~.~ 4. After issuance of a Permit, I expect to: (mark by an (a) Commence work ~ AT ONCE ..... ~...; ASAP ..........:,; UNKNOWN ............. (b) Complete work in ~ I ~AY ............ ; 1 MO ..... ~,.; 1 YR ............. ; ~UTUR[ ............. 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 DP, AWING which will show Ordinary High Water Mark, the shape and size of the dock and any supplemental pilings which ere 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 Town Waters beyond an imagir]~ line or boundary formed by other similar structures along the area's shoreline? YES or~ If it does extend beyond this so-called dock line indicate by how far, approximately ........ Provide the following documents: (a) A Licensed Engineer's Survey of the property involved. (b) A copy af the Contractor's Plans and Specifications. Will this construction require the Filling of any land offshore of the Ordinar,~y-I~igh Water Mark or the Dredging of an.y material from Town La,nds under water? YES o~lf it does, Form A/4 (Application for Dredging/Filling) must be completed and attached as part of this application. 9. 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 th~/Ter~s and Conditions of the Permit, when a.nd if issued tome.~ ~~ ated: / i I