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Home My WebLink AboutMELIN, FRED P/1 Rev/6l72 BOARD OF TOWN TRUSTEES Town of Southold Main Road Southold, New York 11971 Fred Melin To: ................................................................................................................................ 1. Your application, dated ......June 4•a•• 1981•••... ., has been reviewed by this Board, at a meeting of the Trustees held on .......July.•l,•••9al.•••.••••••••••••............•..•••••.••••• and resulting in the action, as indicated below: (............) Application approved. (... ) Application denied. (............) Application tabled. 2. Comments and remarks: To deny application to extend an existing float. 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 some time. If the fee is paid by mail, the permit will be mailed in reply. Computation of Permit Fee: Total Fee for this application ............................................................ $ ...................•.................... igned ..... ,,� �.. .. ..................J.. . Board of Southold Town Trustees. r by ... ... .....P Secretary. A/2 — Rev. 6/72 BOARD OF TOWN TRUSTEES Town Of Southold �� Main Road Southold, New York 11971 APPLICATION FOR FIXED and/or FLOATING DOCKS 1. Applicant's name and address: ......1:.✓�E.............................��/�..�.....7 1 5�- ........................... ............��?..(. .....o G.....�............. .... 9. 5 ............................................................................. 2. Contractor's name and address: ......_ ................................................................................... 3. Briefly explain,-thelpurp a of this` a lica ion: .....�....��NS�u�.........A.....G�v......... � �b�vD 1`'xTu' N� A S loo ......... ........ ...... ..................... d....A..i GCAT...�....�......c..9..N......./..?..v............�...O.Z..I.L..E...k 13vL fir k{riAD S--�............. ... .®a? irxTtw7w� ` ozo1- S';�C /2 ' ro �"X22 ' .................................................................................................................................................................. 4. After issuance of a Permit, I expect to: (mark by an X) (a) Commence work — AT ONCE ............: ASAP ...7......; 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 0. 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. If it does extend beyond this so-called,dock line indicate by how far, approximately...........ft. 7. Provide the following documents: (a) A Licensed Engineer's Survey of the property involved. (b) A copy of the Contractor's Plans and Specifications. 8. Will this construction require the Filling of any land offshore of the Ordinary High 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. 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; 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. L. S. .... ... ......................... Accepted by: Dated: ��. Ow 10 9w Cl) cl) a m AVE UE o FF HOLD ,o Ve�VF -� RD. � = p WEWOO � . D Z E STW 0 DRIVE Nv� � Ord PVE D HAMILT .N y 0 o - ,Op,? ar�� o�o'� '�o'►a�� QK v Ago m 0 a �d ROq o n o � CD 0 HORTON d � � f aA0� 0)9 r m` N aaa�.