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Home My WebLink AboutTR-1469Board Of Southold Town Trustees SOUTHOLDi NEW YORK PERMIT NO .... Z4~9 ............. DATE: ~[~:~ ...2~, ..]~98~L ISSUED TO ...,.~TL[ZZ, J:2*~...~:~A~T~:8:R.8 ..................................................................... nfl oriza ion Pursuanf fo f~e provisions o~ Chaplet 615 o{ fha Laws o~ f~ Sfa+e, o~ New York,, 1893; andC~pfer S+afe o{ New Yor~ J ~; an~ fhe Soufh~ Town Or~nance en- fiflea "RE~U~TIN~ AND, THE P~CIN~ OF OBSTRUCTIONS IN AND ON TOWN 'WATERS AND PUBLIC LANDS an~ fha REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance ResoJu+ion of The Boardadopfed a+ a meefing held 19 80, and in consi~erafion o~ fhe sum of $...20..Q0 paid o .....b~e.e~o~.~.,.;..; ............. ; ......................... N. Y. and su~jecf ~o ~e Terms and COheSions hsfed on fhe reverse side hereof, of Soufhold Town Trus+ees authorizes and permifs fha following: ell in accordance w~+h fhe d~fai~d sp~ifica~ons fhe originating appJicaflon. IN WITNESS WHEREOF, The said Board of Tru~ees ~ere- by causes ~s Corporafe Seal fo be affixed, and be subscribed by a majority of fhe said Bo~d as of fhis daf, e. .................. T~stees BOARD OF TOWN TRUSTEES Town Of Southold Main Road Southold, New York 11971 APPLICATION FOR FIXED and/or FLOATING DOCKS 1 Applicant s name and address: ...................... l..;...<.; ................. .x¢? ................................................ 2, Contractor s name and address: ......... ...~...~...~,..~..< ..~....~...q.......' ....'~_ x...q-:.. ¥. r. x.. ................................. ....... ................ ..... 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 ............ ; 1 MO ............. ; 1 YR ............. ; FUTURE ............. 5. Secure the correct Area Map from the Secretary of this Board, and by using an X WITHIN A CIRCbE 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 and any supplemental pilings which ore needed to hold a floating dock or tie-up a boat. Give al 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 imaginary line or boundary formed by other similar structures along the area's shoreline? ~ or NO. If it does extend beyond this so-called dock line indicate by how far, approximately,. ......... ft. 7. Provide the following documents: (a) A bicensed Engineer's Survey of the property involved. (b) ^ copy of ~he Contractor's Plans and Specifidations. 8. Will this cons~'ruction require the Filling of any land .offshore of the Ordinary High Water Mark or the Dredging of any material .from Town Lands under water? YES or NO. If it does, Form Al4 (Application for Dredging/Filling) must be completed and attached as part of this application. 9. n requesting approval of this application, I submit that: the information presented herein ~s true and correct to the best of mv knowledge and belief; I am the person accountable for ~he 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 the Terms and Conditions of the Permit, when and if issued to me. ..... .................. Accepted by: Dated: ~.~ -~// /~?J