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Home My WebLink AboutTR-201 TOWN OF$OUTHOLD BOAED OF SOUTHOLD TOWN TRUSTEES 8OUTHOLD, NEW YORK WETLANDS PERMIT This Wetlands Permit No, ..2,,,0.,t. ............ has been granted by the Town Trustees according to 241 ~ ~ ~, Ann ~ntMartin & Flor.e...n.c.¢. information furnished in Application No ........................... y ..~, ............................................... Getlman on Nov. 22, 84 ...................................................................... 19 .......... A map of the proposed work will be kept on file in the Trustee Office under the application number given. Permit granted to do the following work .A~p~.~'r''~'v'''a'.~'~.%'9~c~''~n~s..%.r~u.~c''t'~.a~''2'~.x~.4.~..e'~;~D%iQ~ to an ex~sting 50 ft. dock a 3'x20' ramR 2- ~'xl.6,' floa.~.~ ~D.~I,~..~..' x16' float to be constructed in an "L" confiquratio.q the property, and six spiles. Location of propert7 on which work to be done ..Meda~ ...A..v...e..n.u...e.z.....M..a...t..t.~.~.D.¢.~; Creek, Bay or Harbor fronting property .... ..M..a...t..t.i...t..u..c...k.....C..r..e.e..k. .......... ~ .............................................. .... [,,'~,,:.':i'~, '";-'~;;j"'i'~" "dock, 20' ~amp 2- 16' floats and 16' float Width .... z~ .'....~ ~.G ~;., ......~ .: ...~; ~m.p...2 r.. ,4. :.....f..1...°..a..t...s. ~.....8..'.... ;~ ],Q ~.t- ............................ Height Above High Water ....3.....f..t..: ............................................................................... Depth Below Low Water .....~.U..~.T.7..':..~ ............................................................................ Yards to be Excavated ..................................................................................................... Yards to be Filled ......................................................................................................... Manner in which material is to be removed or deposited ......... L.T..-.T..~,U..';.T.7..~ ......................................... 3/.>7 Private- Residential ..... Intended use of prope .................................................................................................................... . Conditions if any .....A.~.R.r...°..v.e...d.....w..i..%...h....t..h..e....]~..r.9.v...i..s.i.9~...~...~h.~..~k..i~..~.%Q~ ....... in an "L" Configuration qoin~ back into the property. . Expiration Date .... ......................... N. umber of inspections Required ...2...i....T. ~r'.u''s.~t~.e~..e.`s'~'~a..r'e'..~t~.~.b''~e'~n~q.t..'i~f'.i'~.e'`d.~.W~D~b~.~QX~ ls complete. Inspection Fees ..~..5..~.Q.0....p..a...i..d. ............................................................................................................ 'Liability Policies in the Amount of .................. The validity of this permit is or may be subject to the approval of other governmental or municipal authorities. The Town accepts no responsibiEty in applying for or obtaining such approval. In the event that such approval is necessary, the ho[der of this permit shal not commence operations here- under until such approval has been obtained in writing. The failure to obtain such other approval when required shall subjecz this permit to immediate revocation by the Trustees upon receipt by the Trustees- of written notice from such other governmental or municipal authorities of its refusal or disapproval. The applicant does by the acceptance of this permit, assume all responsibility for operations under- taken pursuant to this permit, and shal take all precautions for the prevention of injuries to persons ane property resulting from such operations. By such acceptance, the applicant also agrees tc indemni- fy and save harmless the Town, ano its officers, agents and employees from any and all claims arising from operations under this permit and any and all acts or omissions of applicant, his agent and employees. The applicant and the owner and occupants of the premises u pon which the operations authorized by this permit are being conducted, do, by the acceptance of this permit, give cc nsent to the Town, and its officers and employees to enter upon the premises where such operations are being conducted to make such nspections as the Town may deem pecessary to insure that such operations are being con- ducted in conformity with this permit. This operation will not substantially: A. Adversel~ affect the wetlands of the town. B. Cause damage from erosion, turbidity or siltatio~ C. Cause saltwater intrusion into the fresh water resources of the town. D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife and vege- tation or the natural habitat thereof. E. Increase the danger of flood and storm-tide damage. F. Adversely affect navigation On tidal waters or the tidal flow of the tidal waters of the town. G. Change the course of any channel or the natural movement or flow of any waters. H. Weaken or undermine the lateral support of other lands in the vicinity. Otherwise adversely affect the health, safety arid general welfare of the people of the town. Board of Southold Town Trustees Date ...... ALL DOCKS AND BULK- HEADS MUST DISPLAY .... VISIBLE PERMIT NUMBERS. ALL MOORINGS AND STAKES MUST DISPLAY VISIBLE MOORING NUMBERS. BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Main Road Southold, New York 11971 Telephone (516-765-1892) NOTICE OF ACTION - NOT A PERMIT To Mr. Martin & Florence Gellman 1. Your application, dated...1.1./..2.2./.8.4. ...................... has been reviewed by this Board, at a meeting of the Trustees held on...F.e.b.....2.7.,...1.9.8.5. ............. and resulting in the action, as indicated below: (~) Application approved. ": ~- [ ..... ) Application denied. ( ..... ) Application tabled. 2. Comments and remarks: Application approved with the provision that the dock will be placed in an "L" Formation, going back into your property. 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 is the Instruction Sheet (Form I/1). This fee must be paid within 90 days or reapplication and additional fee will be necessary. If the Permit Fee is paid in person to the Clerk 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. 4. Computation of Permit Fee: $5.00 Wetland Inspection Fee now due. Upon remittance, your permit will be forwarded by mail. Total Fee for this application ......................... .. .. $ .............. . . . . President, Board of Sd'uthold.Town True B Clerk. Board of Sout~ol~ ~i-own Tru,C4.~es BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Sou{hold, New York 11971 TELEPHONE (516~ 765-1892 March 28, 1985 Mr. Steven Schumach Department of the Army New York District Corps of Engineers 26 Federal'Plaza New York,- New York 10278 Re: Application No. 85-011-L2 Martin & Florence Gellman Dear Mr. Schumach: Pursuant to your request for comments regarding the above referenced application I have attached a copy of the S.E.Q.R.A. Negative Environmental Declaration for your information, which has provisions that were placed on the construction.of Mr. Getlman's dock. Very truly yours, Ilene Pfiffe~ to Henry P. Smith, President Board of Town Trustees cc: Trustees file Attachments BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York I ~971 TELEPHONE ¢516) 765-1892 NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT Dated: December 27, 1984 Pursuant to Article 8 of the Environmental Conservation Law State Environmental Quality Review and 6NYCRR Part 617, Section 617.10 and Chapter 44 of the Code of the Town of Southold, notice is hereby given that the Southold Town Trustees, as lead agency for the action described below, has determined that the project, which is unlisted will not have a significant effect on the environment. DESCRIPTION OF ACTION Application of Martin & Florence Gellman to repair and extend existing dock and to place a removable ramp and floats with pilings on property located at Meday Avenue, Mattituck, with the provision that the float is constructed in an "L" configuration, directed to the East, so that the structure does not go in front of the neighboring property. The project has been determined not to have a significant effect on the environment for the following reasons: An environmental assessment has been submitted which indicated that no significant adverse effect to the environment are likely to occur should the project be implemented as planned. Because there has been a response from the Southold Town Conservation Advisory Council indicat~lng that this project would not have a significant effect to the environment. Because there has been no response in the alloted time from the New York State Department of Environmental Conservation and the Southold Town Building Department, it is assumed that there are no objections nor comments from those agencies. Further information can be obtained by contacting P~esident, Board of Town Trustees, Southold Town Hall, Southold, New York 11971. Henry P. Smith, Main Road Copies to: Charles Hamilton, DEC, Stony Buook Martin Commissioner williams,-DEC, Albany Southold Town Building Department Southold Town Conservation Advisory Council Town Clerk's Bulletin Board & Florence Gellman BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD Town Hall, $3095 Main Road P.O. Box 728 Southold, New York 11971 TELEPHONE {516) 765-1892 March 28, 1985 Mr. Steven Schumach Department of the Army New York District Corps of 26 Federal Plaza New York, New York 10278 Engineers Re: Application No. 85-011-L2 Martin & Florence Gellman Dear Mr. Schumach: Pursuant to your request for comments regarding the above referenced application I have attached a copy of the S.E.Q.R.A. Negative Environmental Declaration for your information, which has provisions that were placed on the construction of Mr. Gellman's dock. Very truly yours, to Henry P. Smith, President Board of Town Trustees cc: Trustees file Attachments BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 TELEPHONE f516] 765-1892 November 26, 1984 Mr. Frank Cichanowicz, III, Chairman Southold Town Conservation Advisory Council Southold Town Hall Southold, New York 11971 Dear Mr. Cichanowicz: Transmitted herewith is application no~41 for a wetland permit submitted by Martin and Florence Gellman. Please prepare a written report of findings and recommendations with respect to this application. Very truly yours, HENRY P. SMITH, PRESIDENT BOARD OF TOWN TRUSTEES Ilene Pfiffe~ling Secretary to Board Attachment BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York I 1971 November 27, 1984 TELEPHONE '516~ 765-1892 Charles T. Hamilton Alternate Regional Permit Administrator N.Y.S. Dept. of Environmental Conservation BUilidng 40, SUNY Room 219 Stony Brook, New York !1794 Dear Mr. Hamilton: Enclosed is application-of for a Wetland Permit. Florence and Martin G~llman This project is unlisted and our initial determination of non-significance has been made and we wish to coordinate this action to conform our initial determination in our role as lead agency. May we have your view on.this matter. Written commen~s on this projec~ will be received at this office until December 17, 1984 . We shall interpret your lack of response to mean there is no objection by your agency. Enclosures cc: Commissioner Williams Very truly yours, HENRY P. SMITH, PRESIDENT BOARD OF TOWN TRUSTEES Seeretar7 to Board Southold Town Building DeparrmenrL/ BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 Date: November 22, 1984 TELEPHONE (516) 765-1892 To Whom it May Concern: Attached hereto is a Short Environmental Assessment Form submitted by Florence and Martin Gellman to repair and extend an existing dock and to place removable ramp and floats with pilings in Mattituck Creek at property located at 6 Legion Place, Mattituck. ~enr~y.T~. ~, ~ Smith, President Board of Town Trustees Posted: Nov. 22, 1984 TOWN OF SOUTHOLD SHORT ENVIRONUENT^L ASSESSUENT ~NSTRUCTIONS: 'J' (a) In Order to answer the questions in that the preparer w$1l use currently available project and. the likely impacts of the action. FORU this short EAF i~ is as information concerninS It is not expected the additional studies, r~seorch or other investigations v/£11 be undcrtak (b) Zf any question has been answered Yes the project may be signi'ficant and a completed Environmental Assessment Form ~s necessa~ (c) ~ a~l questions have been answered projec~ is not significant, (~) E~onment al Assessmen~ 1. ~i~ prbject result in a large physical change ~o ~he projec~ than 10 acres 2.~ill there be a major change to any unique or -unusual land farm found on the 3.Will projec~ al{e-r, or have a large eF[ec¢ on ·exzstzng body of wo~er? .......... on groundwater quolz%y, ................. Yes ec1 signiflcan~ly effect i [low on adjacen~ si%as?..- ...................... Yes ~. Will project affect any threa%ened or endangered planl or animal sp. ecies? ........... Yes 7. Will projec{ resu!¢ in o major adverse effec¢ on air quali%y? .................. ; ........... Yes .8. Will project have a major effect on visual Ch.aroc~er of ~he community or scenic views or vi's~os kno~vn %o be impor%on¢ ~o ~he community?. Yes ~. Will pro,eot o~versely impact ony si~ or structure o~ historic, prehistoric p~leontologicol desiono~ed as o critical environmental area by a local agency? ................. Yes 10. Will pro3ect have a bo jar effect on existing or fu{ure recreo%z hal opportunities? ......... Yes 11. Will project result in major traffic problems '' or cause o major effecf to exisfing %ronsporiofion system's9 ....................... Yes 12. %~ill pro jeer regularly cause objecfionable '' odors, noise, Glare, vlbraflon, or electrical disturbance as a result of the projec%'s opera~ion9 .................................... Yes 13. Will projec~ have an/ ~mp~c~ O~ public health .... or sot e ..................................... Yes 14. Will project cffec~ %he existing communi~X by directly causing population of zore %hen 5 percent over o one .. year period o~ have o major negative eFfec~ on ~he choroctor neighborhood? ................................. Yes 15. Is ~here public controversy concerning the project?~~ ........................... , __Yes PREPARER'5 SIGNATURe. '/ /,., REPRESENI Regulatory Branch/Eastern Permits Section DEPARTMENT OF THE ARMY NEW YORK DISTRICT, CORPS OF ENiGINEERS 26 FEDERAL PLAZA NEW YORK. N. Y. 1027B March 13, 1985 SUBJECT: Application No. 85-011-L2, by Martin & Florence Gellman Ilene Pfifferling Board of Southold Town Hall, 53095 Main Road P.O. Box 728 Southold, NY 11971 Dear Ms. Pfifferling: We have received a request for Department oil the Army authorization for the following acti'vity: ACTIVITY: Repair an existing 50 foot open-pi/le supported walkway and to construct a 4 foot by 12 foot extension to be elevated 4 feet over the grade of the marsh connecting to a hinged w~ installed "L" shaped float assembly to be sec approximately 80 feet seaward of the line of mea IN: Mattituck Creek AT: Mattituck, Town of Southold, Suffolk Count APPLZCATION BY: Martin and Florence Gellman 6 Legion Place Malverne, NY 11565 As this work is minor in nature, authol Permission. This is in accordance with current work in navigable waters of the United coordination required, prior to the issuance your review of the enclosed drawing is requeste~ Pursuant to Section 307(c) of the Coastal lkramp and outer seasonally ~red by piles and to extend high water; New York ation may be by Letter of =ederal Regulations governing tates. To accomolish the of a Letter of Permission, Zone Management Act of 1972 as amended (16 U.S.C. 1456(c), the applicant has certified that the activity complies with and will be conducted in a man~er that is consistent with the approved state coastal zone management program. / To allow for the timely processing of t~e subject application, your comments are requested within 20 days of the dat~ of this letter. Sincerely, Enclosure James M. M~nsky Chief, Regilatory Branch /1¥, ,~/T/Toot_ c ~e-el(_._ PUBLIC HEARING IN THE MATTER OF THE WETLAND APPLICATION Martin and Florence Gellman SUBMITTED FOR The public hearing was opened at 8:05 P.M. Present were: Henry P. Smith, President John Bednoski, Trustee JohnBredemeyer, Trustee Frank Kujawski, Trustee Secretary, Ilene Pfifferling Mr. Martin Gellman~ Trustee Smith: I would like to open the Public Hearing in the matter of Martin and Florence Gellman for a Wetland Permit. Trustee ~redemeyer will you please read the legal notice? Trustee Bredemeyer: Yes: NOTICE IS HEREBY GIVEN that public hearings will be held by ~he Board of Town Trustees of the Town of Southold, at the Southold Town Hall, Main Road, Southold, New York on WEDNESDAY, February 27, 1985 on the following applications for permits under the provisions of the Wetland Ordinance of the Town of Southold, to commence at 8:00 P.M. Ail persons interested in said matters should appear at the time and place above specified and will be given an opportunity to be heard: DATED: JANUARY 31, 1985 by: Henry P. Smith, President Board of Town Trustees Trustee Smith: Thank you. We also have proof of publication in the Suffolk Times and the Long Island Traveler Watchman. I have an affidavit that this was posted on the Town Clerk's Bulletin Board. In the matter of the application of Martin and Florence Gellman to repair and extend an existing dock and to place removeable r~mp and floats with pilings on property located at Meday Ave. Mattituck. Is there anyone wishing to comment on this application? Mr. Martin Gellmarf£ I would like to establish that there has been question about the registration of the dock. I took over the property in May of 1984, and the dock was existing, at the end of mt there was no ramp. When the dock existed there were a number of floats on the beach. When I spoke to M~s. Pfifferling upon getting the application, she said they were classed the year before soard of Trustees Public Hearing - F~b. 27, 1985 Page 2. - Martin & Florence Gellman There was a survey done, of all docks by some students who were hired by the Town, and the dock was not registered as existing. It has been there about 20 years. I have no proof that it was there, except that seeing it is there. I now have some navigation charts, by Nohah dated 1981, although the detail was small, it shows an existing dock. I just want to establish that it was there. I made an application to extend it, in floats, T wanted to apply properly. There were docks, and piles in the creek,as far back as Trustee Smith: You said you bought the place in 19847 Mr. Gellman: Yes. Trustee Smith: Do you think that when this place was up for sale these docks were taken out for the winter and never put back in? Mr. Gellman: There is a ramp on the beach, no piles or existing docks in the water, but there are 2-IS'floats, plus a 8' x 16' float. I don't know the configuration, but my application indicates, what I imagine exactally how these floats may have existed. I spaken to some neighbors and they said maybe 15 years ago someone had the dock out and this was the configuration. As I said they did exist. Trustee Ku]awski: I think we met. Mr. Gellman: You were out, and you saw the ramp. Trustee Ku]awski: We malked a little about it. I explained that one of the problems, at that time, the property line, it's right on the property line with your nemghbor. We were going to change the configeration to an "L" configeration going back into Mr. Gellman's property. I would like the record to show this. Trustee Smith: Okay. Is there any one else who wishes to come before the board in regard to this application? No response. Then I will close this hearing. 81. Hearing closed at 8:08 P.M. COUNTY OF SUFFOLK STATE OF NEW YORK Ss: Patricia Wood, being duly sworn, says that she is the Edffor, af THE LONG ISLAND TRAVELER-WATCHMAN, a public newspaper printed at Southold. in. Suffolk County; and that the notice cf which the annexed is a printed copy, has been published in said Long Island Traveler-Watch- man once each week for ........................ ./.. ............. weeks successively, commencing on the ............ .~x~x~...~r.. ............. Sworn to before me this ~ ~ff' day of Notary Public BARBARA FORBES Notary Public, State of New Y~rk QugJifled in Suffolk Country Commission Exp~ M~,~ ~, 19 ~ ,Page 16A ". LEGAL NOTICE . '~ ~.~,~ ~redge and fill qn property io. ~, :~,.~A~, OTICE OF HEAR~GS ' ];' ~' .c~.ted at the'end of Sailor s "~' PPLICATION$ - ' ' ' '_I.n the matter ofthe application ~..; NOTICE IS HEREBy GrVEN ~oo~la~_ S. Tessier on behalf of -, ~ya~eub. hc hearings will be held e. ,,~ardiner ,Bay Estates to ..'! - hoard of Town 'l'rus,^--' 'mam;enance dred~ in 2~ the Town of Soutbelr~ ~f'~' to Spring Pone ~outhold Town H q. ~-me Harbor E - '~. ~. qnent · ~u~m~ol.~a, New ' York, :, ~ ~r ~m. the..m, atter of the application ,".~In~;SDAY, February 27 o~ ~-us ltlavas submittcfd by n- .o~o on the followin~ an~ll ' ~onsaltants, Inc to _ _.E · t~'°nsf°rperm'tsUnde;~t~;~'n~'r~~'' ' ' ~ v~ ~(vathln' ' 18") a ~ber b :-2fo~ o~f the Wetland Ordinate OP~oUSm~t~° ret.urns and back/~ll on me'l~)wnofSouthold, tocom - ~- per~y located at - . N. Itiehards submitted b~ , ~.f, Alb~r~ Roke ~ubmittod by ~a.-Consaltants, inc. toconstruc~: :~o,nn, t~ ~deman to dredge in a dock consioting ora ramn and .ocaooLhonse Creek Mon~ ~rn,, · float secured by pili,,~ ~-~ - erty of Katherine ~..~,~- ~,..~_ ~ '~rmg Pumg off of the ~ ~ p~acea on Hartung proo- -~aeast corner of the floor e, ~y. Project location i~ ~ oil end of O1~1 Harbor Ro-;tl,a ~q~nwe property located at Salt Lake Village, Mattituclc SUffolk. ofIn l~i~tgr ortho application of I~athe e~.att?r of the application C. el~-~ .and 'Florence 'o--- ~n~s Way ]~ufldln~ existi ~, t°,repa,r and extend an ~kP°f.~r~attontoCOnstrnstaflxe~ able r , . --~ov- b , ' ~ --~seeurea _ amp and floats with pilin~a ~Y_ .Pti. es at Cedar Beach Drive on property locato~t at i~Ied~v ~as~,-m Pleasant/nlet~ Cedar Ave. MaL~dtuck -' ~.ch, submitted by the Land of ..In, the .matt er of the application ~;.Company. ~to~n catwalk aud floating ~i~ete~l~should appear at the eot a beat. o~ proner~ a place above [ocatod at 15 St~ilwa;--~2 ": and will be ~iven o~ -~ ~ enue, CutchogUe. heard. - Inthematteroftheapplication DATED: January 31, 1985 o~ John Newman to construct ~,H.e~nry p. Smith, President r~prap, remove solid frll walk, ~oard of Town Trustees construct walk and docks, re 1TF14-4785 STATE OF NEW YORK ) ) SS: COUNTY OF SUFFOLK ) ANNA LEKKAS of Greenport, in said County, being duly SWOrn, says that he/she is Principa~ Clerk of THE SUFFOLK TIMES, a Weekly Newspaper, published at Greenport, in the Town of Southold, County of Suffolk and State of New York, and that the Notice of which the annexed is a printed copy, has been regularly published in said Newspaper once each Week for ~ weeks sUccessively, commencing on the ~ dayofFebruar~f__. __ 19 Principal Clerk Sworn to before rne this ~ 4 da j~f February _ 19 85 2/11/85 Spoke to Frank Kujawski and asked if he spoke to Mr. Gellman about changing the confirguation of his dock.~ He said he had and that Mr. Gellman was agreeagle %o this change. The dock will be in a "L" Formation facing away from the property line. Legion Place Malverne, N.Y. November 26, 1984 Board of Town Trustees Main Road Sonthold, NY 11971 Attn: Mrs. Eileen Pfifferling Re: Wetlands Permit filed for Meday Avenue, Mattitudk, NY Gentlemen: I wish to correct the application filed on November 23, 1984, with the following information: "Average rise in tide - 5'2" Thank you for your attention in this matter, MG/ms RESOLUTION No. 21 To declare Lead Agency on the Wetland Application of Martin &Flcrence Gsllman to repair and extend existing dock and to place removable ramp and floats with pilings in Mattituck on Mattituck Creek. RESOLVED that the Southold Town Trustees declare itself lead agency in regard to the State Environmental Quality Review Act in the matter of the application of Ge~lman for a Wetland Permit on certain property Mattituck. Martin & Florence located 6 Legion Place :To~n Of Mou~hold To~rn Clcr.: o O~ke : Southold. ~N~ ¥. A. This opplloa.~ion' is to be completely filled in by typewriter or ink amd submitted to the Town CIerk in quadrupllcate~, ao:zmmaniea by writter permission Dcm the owner o~ the prc~e~' the s~me os the applicant. B. Pilot Pbn ~ust be drown to sc=to am the reverse !ida of this c=mJk=ticm sNcwbg the O{ prc~er~, the names and locations of owners c{ cdjammg ~rc=erties, ~md a dstciled of ~r:p:sed project. (Note: Cap, es of the Rib: Plan may ~e mc~a by a copy mc:hine and Io ~he PermR Application.) ..- ~ No operation s~alI be initiated by the ap;Iicanr until all ;ermi~s that are required are'kzued. D. A detailed statement cf the renc:lhtohan and orcpased ccmditlon at: the premises after the' work i: completed must be given, including a survey if reouired. £. If permit is being' sought for o more sizeable excavation than the construction of a private sidgle dock or jetty, then this application must be accompanied by a survey and tcpcgraphkal mop certified by a r~gistered land survey or Professional Engineer. The horizontal control al: survey shall be based upon an approval local coordinate system. The vertical control for elevation and ings sha!l be based upon United States Coast and Geodetic Survey and/ct United States Geological .~u r~ey datum. F. A statement must accompany the cppJkation describing any known prior operations conducted bn t,~e premises in question and whether any prior licenses or permits have been issued to erect strocmres or to dredge or deposi~ fill on said premises ~nd whether any such permRs or licenses were ever revoked or suspended by o governmental e;ency. G. A filing fee o,~ ~50,00shaJ[ occamgcny the a~g[ic~tlcn. This filing fee includes cna inspection. there is a $5.00 fee far each additional inspect/an. H. The To~n acord upon re~ueste~. ~e ap~Hcanr for o perm,r, may waive in ~'hole er in pan. fha ~r:v,s:cns a~ A~ic[e II, bec::on ~, suacms,ons (~ and ~rwhere it find~ thor nmure of the prc:c:ed cpcrc:,cns ore such ~hat the reouirumenr: of such prov,sions are no[ neccssc~ ~er o I. C.~on :.::rz';at cf this ¢.;~tlcation the Town Ct,irk .,,ill itsue o f. crm,r ;hail ke cvmlcble fcr ms~cct,cn ct any time, upen reque~.t. perrmr ~o the.c~-lictnt. D[sc~orove~ ........................................................... S[gmcture of C~,cirmcn .................................. ' ............................................. ~..~ ..................................... ' ~.~. ~ ~. ~.~r~.~..~.~.~ .~_~. ~ ........................ ~ ...................................................................... :~.....m.....~ ............................. .... ~.~.~ .... : ......... ~._..~~.___._.... C~e~, B~': orH~r.-. .... ,r~.,,.n~ ~r~e~l ................. .............................................. ~, rh,en ..... ~,,. ¢,~ oxvn-.r O~ preach,'-/, if nat the s~m¢ c~ ~he C~Chcc.-.~ IJIA~Y PUBLIC, State of~eW Yo~ ........ No 41-452651~ ...... gmJU~lifi~ in ~s C~' '] ......... ~amn ~pir~ March ~, t~ LLL° / / / //