HomeMy WebLinkAboutTR-1639 GF ALL DCCi~ A~[D BU~EADS MUST DiSPlAY ViSiBLE
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5OUTHOLD. NE~ YOEK
P~l NO, . 1639 - DAT~. July 5,
~ 1
ISSUED TO. ......... ~.~.~.~.b.6...~ .........................................................................
f~e 5~afe o{ New Yor~, t893; an~ Chad,er 40-~ o{ me Laws
Sfafe or New Yor~ 19:z: and me Sou*no~a Town C'dmance en-
f~tled RcGUL~TIN~ AND TH~ PLACING OF OBSTKUCTIONS
IN AND ON TOWN WATERS AND PU~UC LANDS
R.MO/AL Or SAND, GRAVEL OR Ol ...... qAT~IALS F~OM -,
LANDS UNDER TOWN WATff~S; and [n accordance wifh fha
ResoluHcr of The Board ado/ed afa meeting he]~ on .J.~.~...~ ....
~ 9 ....&3, ' .........
ana m c~ns~erarmn ot The sum o~ S 10.00 pa~a by
..................................... : .~AA%h~...~.al ....................................................................
o~ ....... ~.A~.!.~AR.~ ............................................... N. Y. an~ su~[ecf
Terms an~ ~on~[~ons ~is~eg on fhe reverse s~e ~ereo~,
o~ Sou~o~ Town Trusfees aufnor'zes an~ perm~fs fhe
Application approved under the GrAndfAther
~o ~eou~e A permit numbe~ ~or A dooA And BulA-
be~d in ~ttituoA Cree~,
aJ~ ~n accordance w}~ ~e ~e~a]~e~ sDec~ca{}on~ as =resen~e~
app ..... o .
IN WITNESS ~V, ,~R~OF, The sai~ ~oard of Trusfees here-
~ by cause= ifs C~rmoreze, Se~l ,o ~e amxed. ~nd fhese presemz~
sumscnmea by a melonW oF fha sa~d moara as mT fh[s
Z~ ~ ~ / T~astee~
TERMS and CONDITIONS
The Perm2~ Samantha Navel
r~id~ng at Knollwood Lane. Mattituck. N. Y,
pa~ of ~he co~ideradon for ~ ~c~ of ~c P~: d~ ~de~d ~d p~ to ~: fol-
lowing: 1. That the Southold Trus=ees Permit must be prominently
dis~!aved on the premises ~ffected thereby during the period of
2~ ~Ha: ~e ~d ~dof T~s ~d ~e Town of ~u~o/d ~ ~ed from ~v ~d w
~ damages, or da~ for d~ag~, of ~u a~J~g ~y or ~2y ~ a r~r of ~y o~- under
adon ~rfo~d p~t to ~s ~q ~d ~e ~d Pe~ will at ~ ~ her own ~ the
defend any ~d ~I su~ ~ ~t~ by ~ pa~, and ~e ~d Pe~ ~ ~ ~
wi~ r~sp~c, ~cre:o, :o ~ ~mpl~ ~cl~{on of ~ ~d of Tr~ o' ~ Town of ~oldPermlt-',~
3. Th~: ~ Pe~= ~ v~d for ~ ~ of .0%7F ~AR w~ ~ ~d~ to ~
sufficiant ~e r~u{red to compie~e ~ wo:k ~votv~ but ~hould ~:~ w~
for ~ e=e~ion mzv be ~de to ~e B~d at a later da~.
4. ~mt ~s Per~t shoed be rera~ ~def~tety, or as long ~ ~ s~d P~e ~
to maintain the s~e or p~je~ involv~, to provide e~d~qce to ~yone mnccm~ ~ au~- -
orkadon w~ ori~lly obr~ned.
im agenn, and non-comvHance ~Sth the prov~io~ of ~e ori~ma~g appHmHo% ~y ~ ~,=~e for
revocamon of this Pe~ir bv rmoludon of ~e said Bmr&
6. ~nat there w~l be no ~rmsonable [nrerf~ence wi~ na~don ~ a r~t of ~e
herein audmr~ed.
7. That ~here shah ~ no Ntegerenc= wi~ the Hght of ~e ~bHc m p~s ~d rep~ ~ong
~he beach he~eea high and Iow water m~ks.
8.. ~ar g furore ope~io~ of ~= Town of ~old r~uke ~e rmoval ~d/or
in the location of me work her~n =umo~ or g, N ~e opi~ of me ~o=d of T~e~
work sh~ ~use u~e=onable obs~mon to free navigation. ~e s~d Pe~xe= ~H ~
u~n. due notice, to remove or alter ~is work or projec~ herein sta~ed ~ou~ ~ to ~e To~
9. ~ar *he s~d Board will ~ noHfi~ the Pe~=ee ~e of ~e work
by
o~ed. (See tear off sheet.)
~0. ~at the Permkree wHI obt~n all o~er pe~ and co~en~ ~at ~y ~ r~,~
plemenr~ to ~is pe~: whi~ my ~ mbj~ to revoke upon f~e-to ob~ ~me.
?/1 ~ew~.~~
BOARD OF TOWN TRUSTEES
Town of $ou~hold
Main Road
$oathold. New York ] 1971 6~O
~OTICE OF ACTION - NOT A PE~IT [ ~ I ~'
S~m~n~.ha..Na~el~ Knollwood L~ne, ~a~ti~uck, New York 11952
l. Your application, do,ed 6/10/83 has been reviewed by this
Board, at o meeting of the Trustees held on July 5, 1983
ond resulting ~n the action, os ~ndic~ted below:
~X.X..X..X..~ Application approved.
( ............ ) Application denied.
( ............ ) Application tab[ed.
2. Comments and remarks:
Your application was approved under the Grandfather Clause
~o secure a permit number for your dock~ constructed over
15 years ago, in Mattituck Creek. '
Bulkhead also.
A PER,MIT FEE
3. 1~: ,.,Cur e~ol~Catior' iS O~DrOVe.q above. ,~-F', ~-rmff,%-~ is ~o,,~ due. ~n~ should be made D~yob{e
to the, otter of the Basra of Southo!a Town Trustees. This fee ,s comnuted below accord n
~A~¢D-,~u~RB~es~ ~t forth ~n the ~tns~ruc~on Shee%f~crm I/I]. ~his fee must
~v~ :Lt~ .... . ~u ff~y=~or re-appzyzng an~ aa~zczona& Zee wzil be nec~ssaz
~ me rermtt ~e= ,s Dz,s ~n person to the Sec,e~arv of the Boa,~. ~he Permit wdl be obm,nco~e
ar the some time· If the fee is paid by mail, the ~ermit will be mai;ed i~ reply.
Com~utation o~ Permit Fee:
Total Fee for this application ................ ' , 10.00
Signed . .
Pres. Board of Southald Town Trustees
..--1/~ ..~)
BOARD OF TOWN TRUSTEES
Town Of $outhold
Tel.
.......
4. After issuance of a Permit worx mus~ be completed ~'~
LARGE
5. 5azure me ~orrect Area ~cp from the Clerk of this Board an~ oy using a/X V¢ITH~N
map, pray:ac a SCALE DRAWING wmcn will snow Ordinary H,=h '¢/~ter
and size of me dock and any supplemental piiings ~hich ere needed ro hdd a floating dock
..... Cn ~.~z:.,DS O~SEO~ from theO. r~. W.M. E2 ~3eeenc ~o~az%y
docks, specify location and length to scale.
[ne or bounden/ formed by o[her slmiiar structures e~ong the oreo's shoreline? Y52 or NO.
If it d~es extend beyond this sa-called d~k Une ~ndi~ate sy how rcr, approximately,.
7. Prcvide the foUowing documents:
f~) A Licensed Engineer's Survey of the orope~ involve~.
~ ih) A co~y of the Conrractor's P~ans one Specifications.
Shor~ Environmental. Assessment Form.
etlands Appl lc,etlon
Mark or the Oredgmg of anv material from Town Lands under water? YES or NO. If ff does,
Farm A/4 (AppHcanon for Dredging/FM'ng) must be carr:~erea aha arrccnea as ~rt of this
application.
9. In requesnng approval of this application. [ suO~it thor: the mfermcnon uresented herein
Permit, when aha it issued ro me.
lO. To expedite finding specific !ocean ~r ir. speq~ion, lindicate
by using a ~emporary marker~
· ::~:::::' 'A/2 RES:' 2/82 ... ~ L. S.
BOAIID OF TOWN TRUSTLE$
Town Of Southold
$outhoht. ' '
~ew ~orx ]2971
~Iain I{oad
APPLICAT, ONFORABULKHEAD. DIKE, OR JETTY
1. Does this prelect involve the use of WETLANDS os defined in the $outhoId Town Wetlands
Ordinance? YES or NO. I'I: it does, you mus~ fife through the Town Clerk's Office~
2. ~s the proposed work entirely within the boundaries of your own prope~v as substantiated
by your Deed ar Su~ey? YES or NO. If it is, a Permit is NOT required from mb B~rd,
but ~he Town Building Inspector should be c~ntocted for ful~ details.
.........................................
4. Contractor% name and address: ....................................................................................................
.......
..... ..... ;. ....... ........ .............
........ ...........................................................................................................
6. After issuance of Permit,WOrk must be completed w~th&n one year.
~RGE
7, Secure tbs correc~ Are~ ~p ~ro~ the Clerk of this Boor~. and by us[n~a/ X
A CIRCLE os o mark, indicate os closely os possible the location of tn~s prelect. Or~ the
reverse side, provide o SCALE D~WING which wil) show Ordinary High Water Mark as well
os me size OhO shape of me structure or work to be done. Also include oil dimensions for
pornens which extend offshore from the O~ H. W. M. State Adjacent property
8. Provide the foJlow~ng documents:
(ol A Licensed Engineer's Su~ev of the Droper~y involved.
(b) A copy of the Contractor's Plan and 5secificofions.
(e} Short Environmeneal Assessment Form.
9. Does this prelect extend into Town Waters beyond on ~magino~ line or boundary formed
by existing works of a s~milar nature along this oreo's shoreline? YES or NO. If ~t does, state
the approximate distance beyond, , ...........
10. WHI this construction reou~re lhe FilZing of any land offshore of the Ord[no~ High Water
Mark or the Dredging of any material from Town Lands under water? YES or NO ~f it does,
Form Al4 (Application for Dredging/Filling) must b~ completed and attached os parr of
application.
] t In reouesting acaroval of Chis application, submi~ that: the information presented herein
is true and correct to the best of my knowledge and belief; I om rne person accountable for
the performance of the wor~ in accordance wi~h the p~ons and specifications attached; I nave
reoa or am familiar wit~ rne provisions of any Southold Town Ordinance pertinent to the work
involved; and further. I intend to adhere to and o~ide by the Terms end Conditions of the
Permit, when and if issued re me. ON FO~~
A/~ Rev. . ., -