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HomeMy WebLinkAboutTR-955 : ld Town i( UTHOLD, NEW 'fORK - PERMIT NO. ~ r ;: ISSUED TO ~ g. Getches ~ .... ........................ /T i" Pursuarrt . of Chapter 615 of the +he State of New Yorl~ 1893, and Chapter 404 of the L~.aws of the State of New York 1952: and ('he Sou+hold Town Ord nartce .~en- : fi~ed 'RE~ULATIN~ AND THE PLACIN~ OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC ~NDS and REMOVAL ~ SAND, ~RAVEL OR OTHER MATERIALS FROM LANDS UNDER TOW~ WATERS;" and in accordance Resolution of The Boara adoptedaf a meeting held on ...~e_.~.~.~ 19 end ln conslde~af~on ~ ~ sum of 0o by '~ JoseRh P~' Getche~ of Sou+hold Town Trusfee~ au+hOrize~ and Build a fixed 2 ft. :by 10 on the John Tuth~ (With at Orient -New ¥o~k. ~ detailed affixed, and these p.resents +he sa,d Board as' of.+h,s dat, e.? A/2 - Rev. ~/72 BOARD OF TOWN TRUSTEES Town OF Southold Main Road Southold, New York 11971 APPLICATION FOR FIXED and/or FLOATING DOCKS ,. App'ea shame and address: ....... ........................... ............. ....... ...... 2. Contractor's name and a~dress: ..~~ .................................................................... 3. Briefly explain the purpose of this application:. 4. After issuance of a Permit, I expect to: (mark by an X) (a) Commence work -- AT ONCE ............ ; ASAP ............ ; UNKNOWN ............. (b) Complete work in 1 DAY ..... ; ] MO ............. ; ] YR ........... ; FUTURE ............. 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 DRAWING which will show Ordinary High Water Mark, the shape and size of the dock end any supplemental pilings which are 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 fram the O. H. W. M. Will any portion of this construction extend offshore into Town Waters beyond on imaginary line or boundary formed by other similar structures along the area's shoreline? YES or NO. If it does extend beyo, nd this so-called dock line indicate by how ~r, approximately,.......~ Provide the following documents: (o) A Licensed Engineer's Survey of the ~roperty involved. (b) A copy of t'he Contractor's Plans and Specifications. Will this construction require the Filling of any [and offshore of the Ordinary High Water Mark or the Dredging of any material from Tow, Lands under water? YES or NO. If it does, Form A/4 (Application for Dredging/Filling) must be completed and attached a~6~'~rt of this application. 9. in requesting approval of this application, I submit that: the information presented herein is true and correct to the be~t of my knowledge and belief; I am the person accountable for the performance of the work in accordance with the plans and specifications attached; 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 the Terms and Condition. s~of the Permit, when and if issued to me. , , . /