HomeMy WebLinkAboutTR-1265Board Of $outhold Town Trustees.
SOUTHOLD, NEW YORK
PERMIT NO. 12.6.5 ...................
DATE: ..N_Q~/.......2.~....~.977
ISSUED TO ............ ~.~...L.,.....~;~.~ ~ ........................................................................
, at'l riz'ati n
Pursuant to {'he provisions of Chapter 615 of the Laws of
the State of New York, 1893; and Chapter 404 of the Laws of 1-he
S{'ate of New York 1952; and 1-he Southold Town Ordinance en-
titled "REGULATING AND THE PLACIN$ OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIG LANDS and 1-he
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and in accordance with the
Resolution of The Board adopted al- a meeting held on
19..~7..., and in conslderafion of the sum of $5~.~ ......... paid by
..................................................... ~'p.n,~....~., ..H!.~ ~,.~y .............................................................
of ....... ~.~.'~g'~.~., ............................................... N, Y, and subiec{' to 1'he
Terms and Conditions lls1.ed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the following:
dredging of an area in £ront of private property
of the applicant of approximately 12 o oy~
all in accordance wlfh the detailed specifications as presented in
the originating application.
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes its Corporate Seal 1-o be affixed, and these presents to
be subscribed by a maiorlty of the said Board as of this dat.e.
A/4 - Re~. 6/72
BOARD OF TOVdN~'TRUSTEES
Town Of Southold
Main ROad
Sonthold, New York 11971
APPLICATION TO DREDGE and or FILL
1. Does this pro)ect involve the use of WETLANDS as defined in the Southold Town Ordinance
'n Wetlands? YES or NO. If it does, your application must be filed through fha Town Clerk's
Office,
2, Applicant's name and address:
.................... /
........ ..................................................................................................... ....... ........
3. Contractor's name and address: ........... ~...~....~..'~.. ........................................................................
4. Explain briefly the purpose of this application: ..... ~..~/...~.?'../...~{.~.....~...~.!..L~..~...~..~.....L..~.. .......
...... ....... ......
...............................................................................
5. After issuance of Permit, I exper to: (mark with an X)
(a) Commence work ~ AT ONCE ............ ; ASAP ............ ; UNKNOWN TIME .... ~ ....
(b) Complete work in ~ 1 DAY ............ ; 1 MO ............. ; 1 YR...~.~; FUTURE ...~ ......
6. Secure the correct Area Map from the Secrefa~ of this Board, and by using an X WITHIN
A CIRCLE as a mark, indicate as closely as possible the I~ation of this work. On the reverse
side of this ~, provide a SCALE D~WlNG which will s'how the OrdJna~ High Water
Mark ~nd the s~ze and shape of the structure or work. All dimensions offshore of the
O. H. W. M. should also be shown and include any free standing pilings which will remain
at completion.
7. Provide the follow~ng d~uments: (a) A Licensed Engineer's Survey of the property involved.
(b) A copy of the Contractor's ~lans and Specifications.
8. Has any previous application for this work been denied by any other local government agency?
YES or NO. If ff has been, n~me the agency...~(..~. ............................................................
Date of denial ........................................
]f dredging is contemplated, give your estimate of the following.
(a) Average depth of water at' M. L. W.where dredging, '~/~' ft.
(b) Maximum depth of dredging below the bottom,
(c) Maximum length of dredged area ............................... L.'~....~... ............................... ft.
(d) ,Maximum width of dredged area -'~-"J ft.
(e) Maximum amount of material to be dredged & ~ c. yds.
If filling is expected, give your estimate of the following:
(a) Maximum amount of material required,. ................................................................... c. yds.
(b) Explain how fiji wiJJ be obtained and where it will be placed.
] 1. In requesting approval of this application, I submit that: I am the person eccountable for the
aerformance of the work in accord with the plans and specifications attached hereto; !
have read or am familiar with the provisions of any Southold Town Ordinance pertinent to
the work involved; and furfher, I intend to adhere to and abide by the Terms ~nd Conditions
of the Permit.
Ac .c.~e d~~/ ~j Dated: :J
C~e e ~