Loading...
HomeMy WebLinkAboutTR-1097Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO ...... J.0.9:7 DATE: ,ZtCLy...~Z,,.....J. 9?5 ISSUED TO .......... ~h.& ],&]~ ...]~Q.~. ,......,T. ZT ................ Pursuanf '~o t'he provisions of Chaplet 615 of fhe Laws of {he Sfafe of New York, 1893; and C.hapfer 404 of fhe Laws of fhe Sfa+e of New Yor} 1952; and fhe Soufhold Town Ordinance eh- filled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and fhe REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and-in accordance wffh fhe Resolufion of ~he Board adopfed afa meef~ng held on ..~y....T.~ .... 19..Z5., and in con~deraflon of fhe sum of $...5~.~.Q. paid by ............................. ~ZZ~...2~oeZ, ..Z~ ............................................................................. of ........ ~~ ........................................... N. Y. and subjecf fo fhe Terms and Condifiodg lisfed on fhe reverse side he.of, of Soufhold Town 'Trusfee~ aufhorizes and permifs fhe following: all i. accordance wifh fhe derailed speclflcafions as pre.riled in fhe or[gbafbg appl[cafion. IN WITNESS WHEREOF, The said Board of Trud'ees here- by causes ifs Corporafe Seal to be affixed, and fhese presenfs fo be subscribed by a majorify of fhe said Board as of ~'his daf,e. Trustees BOARD OF TOW-N TRUSTEES Town of Southolcl Main kqoa el Southold, l~ew York 11971 l~ilL i~hoe~, ~r.~ Lu~to~'~ P~..~ Toad~ Matii%uck, N~Y. 11952 To: . - ~ .................................................................................................. , ]. Your application, do~ed ..~..~.~.....~7~ ....................... has ~een reviewed by this Board, at a meeting of the Trustees held on ......... ~[~q..7.~...J.9~.~ ...................................................... c~nd resut~ing in the action, os indicated below: (.._3{_~..) Application approved. ) Application denied. ) Application tabled. 2. Comments and remarks: 3. If your app!ication is approved above, A Permit Fee is now due, and should be made payable to the order of the Bc~ard of Southold Town Trustees. This fee is computed below according to the Schedule of Rates as set forth in the Instruction Sheet (Form l/1). If the Permit Fee is paid in person to the Secretory of the Board, The Permit will be obtainable at the same time. If the fee is paid by mail, the permit will be mailed in reply. Computation of Permit Fee: Rebuild existing dock = ~5.00 Total Fee for this application .......................................................... $ ..i...5...QO....D. LT~ ............. Signed ..... ~ ~/-~Y-[-:~ Z, ~ ................... Chin. Board of Southold Town Trustees. by BOARD OF TOWN TRUSTEES Town O~ Southold Main Road Southold, New York 11971 APPLICATION FOR FIXED and/or FLOATING DOCKS 2. Contractor's nome and address: ..................................................................................................... 3. Briefly explain the purpose of this application: ..................... ~ ......... ...~...~.. ......................... ;~- ......... ............... .Z, ............ = .................. ................ ........ '/.z... After issuance of a Permit, I expect to: (mark by on X) (a) Commence work -- AT ONCE ~ ...... ; ASAP ............ ; UNKNOWN ............. (b) Complete work in -- 1 DAY ............ ; 1 MO.../~......; 1 YR ............. ; FUTURE ............. (~ Secure the correct Area Mop from the Secretary of this Board, ,~nd 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, '(he shape and size of the dock and any supplemental pilings which are needed to hold a floating dock .or tie-ua a boat. Give all 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 i.nto Town Waters beyond ~n imagj~af~ I ne or boundary formed by other s m ar structures along the area s shoreline). YES~r NO./NO. If it does extend beyond this so-called dock llne indicate by how fair, approximately,.....~ 7. Provide the following docu,ments: (a) A Licensed Engin,eer's Survey of the property involved. (b) A copy of the Contractor's Plans and Specifications. (~ Will this construction require the Filling of any land offshore of the Ordina,l~y '~gh Water Mark or the Dredging of any material from Town La,rids under water? YES o~ NO Jif it does, Form Al4 (Application for Dredging/Filling) must be completed and attached~s~'a~rt of this application. Accepted by: In requesting approval of this application, I su'bmit 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 the Permit, when and if issued to me.