HomeMy WebLinkAboutGUINAN, GEORGE BOARD Or T071N TRUSTEES
CREEK A Town of Southold
Main Road
YOUR ORIGINAL PEP-MIT NUMBER Southold, New York 11971
APPLICATION FOR SPECIAL ICE DAMAGE PERMIT
INSTRUCTIONS : Fill out form below and return to above address. You
should have this application approved and
returned to you within a week.
1. Applicant's Name & Address : . . . .1.O . y. . . . . . . . . . . . . . .
. . . . . . .—7. 11.4�1(� b�.��z���. L ,1:. . f1CWQ1 . . . . . . .Tel. No73 . .. �`1 .
2. Contractor 's Names & Address : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...
. . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . .Tel. No. . . . . . . . . . . . .
I. The purpose of this application: Redriving or replacing openwork
dock or openwork pier piling, and mooring piles, removal of damaged
piling, repair, resetting or replacement of floating docks, ramps ,
or - decking, all necessitated by ice and storm damage resulting during
1966-87 Winter.
SPECIAL CONDITIONS
1. No dredging or filling is permitted.
2. Repairs to existing structures shall be limited to replacement of
timbers without change in design or dimension.
3 . No repair or replacement of bulkheads is permitted under this permit.
4. No freshwater or tidal wetlands are to be disturbed under any
circumstances.
5 . A yellow permit sign provided by this office shall be displayed on
the project at all times while under replacement.
6. Original permit numbers (3 " high) must be permantly displayed on
project.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Tear off and return)
I, , certify that the work as authorized in
this permit has been completed and is now ready for your inspection.
Also, the permit number required on this project is clearly visible. .
PER.NJIT hrUMBER
SOUTHOLD ToUili u
jjr2 e
NO.
Issued ToCtcoree, fl. & "lN6r%) Date �T g (g��
Address Neck Lavie-01 Pecom,c-,
THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION
TOWN TRUSTEES OFFICE. TOWN OF SOUTHOLD
SOUTHOLD, N. Y. 11971
TEL: 765-1801