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Home My WebLink AboutTR-1077goard Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO ...... z0ZT. DATE: ~T~:.~e ISSUED TO ......... qE~:~- .:5... ~;~.~.~ .............................................................. Pursu~n~ {o ~he provisions of Chad{er 615 of fha L~ws of fhe Sfafe of New ~ork, 1893; and ChaFfer 404 of fha Laws of fhe Sfafe of New York t952: and fhe Soufho]d Town Ordinance en- flfled "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;" end [n accordance wffh fhe Reso[uf~on of The Board adopfed afa meefing held on ~e 2~ ..... 19..]5...., ~nd [n cons[der~fion of fhe sum of $ .....Z~.~B~ p~]d by .................... ~¢~. of ............................ ~g.~?z~.~.~ .......................... N. Y. ~nd sub]ac+ fo fhe Terms end Condff;ons [isled on- fhe reverse side hereof, of Soufho[d Town 'Trusfees a~fhor~zes ~nd permifs fhe following: Pe~ission to p!~ce re~p !2x3~ ~to~¢ing dock 18x5~8"~ wi~h ~ mooring piles i~ Jockey Creek directly {n front of his property at Yotmg's ~ad Wes~ ~u~!d~ N~Y. ail [n ~ccordance wffh ?he de{'a[[ed spec[f]caf[ons as pre~enfed ]N WITNESS WHEREOF, The said Board of Trusfees here- by c~u~es frs Corgorsfe Seal fo be affixed, ~nd fhese presenfs be s~bscribed by a ma]orffy of +he said Board as of fhis P/1 Rev/6/72 HOARD DE TOWN TRUSTEES Town of Southold Main Road Southold, New Fork 11971 To: .......G C1..A.0... ................. L Your application, dated .........1<'ar..27,..?975...................................... has been reviewed by this Board, at a meeting of the Trustees held on ................JuM'P za...!Vfi ...................................................... and resulting in the action, as indicated below: (...XX.....) Application approved. (...........J Application denied (............) Application tabled. 2. 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 Southold Town Trustees. This fee is computed below according to the Schedule of Rates as set forth in the instruction Sheet (Form 1/1). 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 by mail, the permit will be mailed in reply. Computation of Permit Fee: Ramp a 12ft, x 3 ft, = 36 sq, ft. - @ 100 sqc ft, 3,60 Float a 18ft. x 5:011 =102 sq, ft, — @ 105! sq, ft. =------------s_----- 10,20 2 Foorin.- Piles @ $1,00 each = -----------------------—---—----- 2,00 $715-80 Less filing 5,00 fee $ 10,80 Total Fee for this application ............................................................ $ .....10.80...Fee Dae Signed ... .GOLl3S?iITH . . . . ................................. Chm. Board of Southold Town Trustees. by ...... ... . . •....... .. ............ Secretary. w., A/S Rev. 6/72 { BOARD OF TOWN TRUSTEES Town Of Southold Main Road Southold, New York 11971 APPLICATION FOR FIXED and/or FLOATING DOCKS i 1. Applicant's name and address: ..... ...........I....................... ...................................... ....... ..... .. ...........................................FAL. I......'......... . f j...t��7 �........ .. .................. 2. Contractor's name and address: .......... �/.-.......a!�.....:5'.eg.• 4!;; ..................................... i 3. Briefly explain the purpose of this application: ......T.° Cv..Al,� ...........� i 6 ..T! r, „ ;�ac� .-r-v s � a4��✓e,F�=e;= ......!�� T`v�..... ��.�S L � c e¢� <- r�v.v ........................................................................................................................................................ 4. After issuance of a Permit, I expect to: (mark by an X) (a) Commence work SAT 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 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, the shape and size of the dock and any supplemental pilings which are needed to hold a floating dock or tie-up 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 into Town Waters beyond on imaginary Line or boundary formed by other similar structures along the area's shoreline? YES or NO. o: If it does extend beyond this so-called dock line indicate by how for, approximately,..........ft. 7. Provide the following documents: (a) A Licensed Engineer's Survey of the property involved. (b) A copy of the Contractor's Pians and Specifications. 8. Will this construction require the Filling of any land offshore of the Ordinary Nigh Water Mark or the Dredging of any material from Town Lands under water? YES or NO. If it does, Form A/4 (Application for Dredging/Filling) must be completed and attached as part of this application. /V Z) 9. 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; 1 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. L. S. .. ` �1..•... � ' .Accepted Dated: S/21/� � n. Ir t 4 Jug to w Qvr v .SWC v a Au A nr 71 GAL elf,- K' l ' 77 Ono w r f L (• " ? 3V of �� ,< F . it' f F i { 7 MAP OF L.fi�;No oxD E� � Sulzv�:YFD FOR., JOHN -s LILLIAN M . 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