HomeMy WebLinkAboutRAYNOR, MERVINB6ARD OF SOUTHOLD TOWN TRUS~T~S
To ~
rev/6 j 72
1. Your application, dated has
Board,at a meeting of the Trustees held on
and resulting in the action, as indicated below:
e
been reviewed by this
Application approved.
( ) Application ~~
( ) Application
Comments and remarks:
3. If your application is approved above, A Permit Fee is now due,
and should be made payable to the order of the Board of $outhold
Town Trustees. This fee is computed below according to the Schedule
of Rates as set forth in the Instruction Sheet (Form I/1)
If the Permit Fee is paid in person to the Secretary of the
Board The Permit will be obtainable at the same time. If the fee is
paid gy mail, the permit will be mailed in reply.
Computation of Permit Fee:
Total Fee for
this application: ............... $
Signed: VChm. '~oard'of Southold Town Trustees.
by.
S~cretaryo
~ OF SOUTHgI,D TOWN TRUST~.~S
To: James H~ Rambo.. ln~_a/c MArvin Raynor
and
Wunneweta Road, Cutchogue, N.Y.
Your application~ dated June 30, 1972
~a~ a meeting of the TruStees held on
resulting in the acti6n; as indicated below:
~_ ) Application approved.
( _} Application denied.
has been revl
(_ .) Application tabled.
Comments.and remarks:
Upon znves'tigation~of the application of Mervin Raynor
zt wax determzned that this new cons%ructzon lslent~rely
on the applicants l~roperty, and therefore does n~t come
the jurisdiction'of the %'own Trustees.
3. If your application is approved above, A Permit Fee~.~S now due;
and should be made payable to the order of the Board~'pf $0qthold
Town Trustees. This fee is computed below'according t6.the'$chedule
of Rates as set forth in the L~struction Sheet (Form I7i)' ~- i
If the Permit Fee is ~aid in person tO the secretary bf he
Board, The Permit will be ~b,tainable at the same time. If the fee is
paid by mail, the permit will be mailed in reply·
Computanion of Permit Fee: ~";
Total Fee for ~his application: ............... ~ ,none
Si . ~
BOARD OF ~OUF~,OLD TO?~N TRUJTEES
rev/6 72
APPLISATION FOIl A BULKHEAD, DIKE, OR JETTY.
Does this projec: involve the use of WE~.~S as defined in the
Southold To~m Wetlands Ordinance? YESoi~O/ If it does~ you
must file throush the Town Clerk's Office
e
Is the proposed work entirely within the:-bound~r~es~your o~
property as substantiated by ~our Deed o,~ R~rvey~ lYES)or
If it is, a Permit is NOT required from this Board,~n the
rown ~-~ Inspector should be contacted for full details
Applicant's name & address: ~ ~ ~. ~.
Contractor's name & address
Explain briefly the purpose of this application: ~
After issuance of Perm%t, I exoect to: (mark with an X)
(a) Commence work ..... AT ONCE ~ ~ ASAP .; UNI~O'WN TIME.
(b) Complete work ino~IDAY; 1MO. ~/'; 1YR.__; FUTURE
Secure the correct Area Map, from the Secretary of this Board, and
by using an X WITHIN A CIRCLE as a mark, indicate as closely as
possible the location of this. project. On the reverse sides
provide a SCALE DRA~ZlNG which will show Ordinary High 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
f:om the O.H.W.M.
Provide the followin~ documents: (a) A Licensed Engineer's Survey of the properny involved.
(b) A copy of the Contractors Plans & Specifications.
Does this project extend into Town Waters beyond an imaginary
line or boundary formed by existing v~s of a similar nature
along this area~s shoreline? YES or Q~[O)__~ If it does, state the
approximate distance beyond, ft.
10.
Will'this construction require the Filling of any land offshore
of the Ordinary High Water Mark or t~redging of any material
from Town Lands under water? YES or(NOJ If it does, Form A/4
{Application for Dredging/Fitl~be completed and attached
as part of this application°
11. 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 spec~
ifications attached; I have read or am familiar with the pro-
vis ions of any $outhold Town OrdLnance 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 ~o me.
XXXXiz~XX_~KXXXXXXXX~XXXXXXXXXXXXXXXXXXX~K~XXXY~XXXXXXXXXXXXXXXX~XXX?~XX.X
Accepted by: ~-~z7 Dated: 7~_ ~O~
· GREAT
PECONIC
8AY