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Home My WebLink AboutTR-1176Board Of-$outhold,-Town Trustees SOUTHOLD, NEW YORK PERMIT NO .... ]-!~Z~ ................. DATE: ~.~p~;.....~.3......~97 ISSUED TO ........................... ~'~ .~,,~:~:RD_. ~...... ~ L~gZ',T .................................................. Pursuant to the provlslons of Chapter 615 of the Laws of the State of New York, 1.893; and Chapter 404 of the Laws of the State of New York t952, and th~ Sob~hold Town Ordinance en- titled "REGULATIN~ AND THE PLACIN~ OF OBSTRUCTIONS tN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GR, AVEL OR:OTHER:MATERIALS FROM LANDS UNDER TOWN WA~RS;" and iff accordance wife Resolution of The Board adopted afa meeting held on S~.,....[3 · 19...!~.., and ~n con~derafion of fee sum of $ ....~.~.gQ .......... paid by ...... E~d...W.. ~ixon " 6"'"~'~'~"'L6~'"'~b'~, ...................................................... of .~$.~.P~.,_....~.,.~.,........~.[~.~7 .......... N. Y. and subiec~ ~o the Terms and Condif]ons llsfed On ~he reverse sl~e hereo~, of ~ouf~old Town 'Trusfees a~horlzes and permifs f~e followbg: a. ,n accoraance with fha ~efai[ed specificafions as presented in fha origlnafing applicafion. IN WITNESS WHEREOF, ~e said Board of Trusfees here- by causes ifs Corporate Seal fo be af{ixed, and f~ese presents be subscribed by a maiorffy o~ the said Board as of +hi~ daf,e. .......................................... Trustees TERivlS and CONDITIONS The Permittee. r~iding at N.Y., as pan of the consideration for the issuance of the Permit d0~ understand and pmscafbe to the fol- lowiug: 1. That the said Board of Trustees and the Town of Southold m-e released from may all damages, or claims for d~m~ges, of suits arising d~xectly or ~nddrectly as a result of any oper- ation perfo~-med pursuant to this permit, and the said Permit~e wilt, at his or her own expense, dc~end any and all such suits initiated by third parties, and the said Perm~ttee asmmes ~ *-i respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold 2. That this Permit is valid for a 15edod of mos. wtffch is cons~ered to be the estLmated tkne required to complete the work involved, but should dr~ces warrant, request for an extension ma be made to the Board at a later date. ( Y 3. That this Permit should be retained indefinitely, or as long as the said Pexmlttee wishes to ma/ntain the structure or project invulyed, to provide evidence zo anyone concerned that auth- orization was or:iglnalty obtained. 4. That the work involved will be subject to the inspection and approval of the Board or ks agents, and non-compliance with the pro~qsions of the orlgina~ag appHcatlon, may be cause for revc<ation of this Permit by resohtio_n, of the said Board. 5. T~at therfi Will be mo tmrea~onable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and iow water marks. 7. That if future operations of the Town of Southgld require the removal and/or altemtiorts in the location of the work herein authorlzed, or if, in the opi~on of the Board of Trustees, the work shall cause unreasonable obstrucnon to free navigalSon, the said Permittee w[ll be upon due notice, to remove or alter this work or project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee or the completion of the work auth- orized. 9. That the Permittee will obtain ali other permits and consents ~hat may be required strp- plementai ro this permit which may be subject to revoke upon failure to obtain sam~ BOARD OF TOWN TBUSTEES Town Of $outhold $outhold, N~w York 11971 Main Road 6/72 APPLICATION FOR A BULKHEAD, DIKE, OR JETTY 1. Does this project in~;~fe the use of WETLANDS as defined in the Southold Town Wetlands Ordinance? YES or~_2 If it does, you must file through the Town Clerk's Office. 2. Is the proposed work entir~within the boundaries of your own ;~roperty as substantiated by your Deed or Survey? ~ or NO. If it is, a Permit is NOT required from this Board, but the Town Building Inspector should be contacted for full details. 3. Applicant's and address: ~.~.~)~/]¢'.~c,c,c,c,c,c,c,c,c,~,, ........................................................................... ........... ............... 4. Contractor's name and address: J,.....~...~~.....~......,..'¢~....~......~..~...%~....~...~z.. ...................... 5. Explain briefly the purpose of this app~icati~m/..~.~.~...~....Z~...~.~..~../~...~..;~...~....~.~.~..~.'~. After ~ssuance of Permit, I expect to: fmark with an X) (a) Commence work AT ONCE ............ ; ASAP .~i ...... ; UNKNOWN TIME ............. (b) Complete work in 1 DAY ............; 1 MO .............. 1 YR..~.......; FUTURE~ ............ Secure the correct Area Map from the Secretary of this Board, and by using a~ X WITHIN A CIRCLE as a mark, indicate as closely as possible the Ioca'~ion of this project. On the reverse side, provide a SCALE DRAWING which wil show Ordinary Hig'h Water Mark as well as the size and shape of the structure or work to be done. Also include all dimensions for portions which extend offshore from the O. H. W. M. Provide the following documents: (al A Licensed Engineer's Survey of the property involved. (b) A copy of the Contractor's Plan and Specifications. Does this project extend into Town Waters beyond an maginery line o~r=~oundary formed by existing works of a similar nature along this areo's shorelineS. YES or,If it does, state the approximate distance beyond,. .......... :' ft. Will this construction require lhe Filling of any land offshore of the Ordina~gh Water Mark or the Dredging of any material from Town Lands under water? YES o N(,~.'lf it does, Form A/4 (Application for Dredging/Filling) must be completed and attached as part of this application. In requesting approval of this application, I submit that: the information presented herein is true and correct to the best of my knowledge and belief; I am the person accountable~for the 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 ~he Permit, when and if issued to me. L¥