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HomeMy WebLinkAboutTR-2074 James F. King, President QF soUry Town Hall Annex Bob Ghosio,Jr.,Vice=President O� O0. 0 54375 Main Road P.O.Box 1179 Dave Bergen :: Southold,New York 11971-0959 John Bredemeyer G • �O Telephone (631) 765-1892 Michael J.Domino O Fax(631) 765-6641 COUNTN,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 13, 2013 Ms. Lucie Harris 521 6th Avenue Brooklyn, NY 11215 RE: 305 PRIVATE ROAD #3, SOUTHOLD SCTM# 70-6-12 Dear Ms. Harris: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, November 13, 2013: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit#2074 from Lawrence Marks to Lucie Harris, as issued on September 25;' 1985, and Amended on August 2, 1993. If you have any questions, please contact our office at (631.) 765-1892. Sincerely, o�-110 James F. King President, Board of Trustees JFK:amn SUEPO�,�- James F.King,President �p� �pG P.O.Box 1179 Bob Ghosio,Jr.,Vice-President j Southold,NY 11971 Dave Bergen y Telephone(631 765-1892 John Bredemeyer ,y T Fax(631)765 6641 Michael J.Domino O 'F Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: LUCIE HARRIS requests a Transfer of Wetland Permit#2074 from Lawrence Marks to Lucie Harris, as issued on September 25, 1985, and Amended on August 2, 1993. Located: 305 Private Road #3, Southold. SCTM# 70-6-12 Type of area to be impacted: _Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 Chapt. 111 other Type of Application: Wetland _Coastal Erosion _Amendment —Administrative—Emergency Pre-Submission Violation Info needed: Modifications: Conditions: ©,Af. - Present Were: J. Kipg B. Ghosio D. Bergen, J. Bredemeyer ✓ Michael Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: James F.King,President \\Of so Town Hall Annex Bob Ghosio,Jr.,Vice-President �Q� yO�o 54375 Main Road P.O.Box 1179 Dave Bergen Jx[ Southold,New York 11971-0959 John Bredemeyer G Q Michael J.Domino Telephone(631)765-1892 Cow m,��' Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0857C Date:May 17,2013 THIS CERTIFIES that the 4'x42' catwalk• 3'x12' ramp. 6'x12' float in an"I" configuration At 305 Private Road#3-Southold New York Suffolk County Tax Map#70-6-12 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 9/1985 pursuant to which Trustees Wetland Permit#2074 Dated 9/25/85,was issued and Amended on 8/2/93,and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the 4'x42' catwalk: Yx12' ramp-,6'x12' float in an"I"configuration. The certificate is issued to LAWRENCE MARKS owner of the aforesaid property. /L" C Z J Authorized Signature TRUSTEES g11FFOL. SUPERVISOR John.M.'Bredemeyer,III, President ell SCOTT L.HARRIS ' Albert J.Kmpski, Jr.,'-Vice President � y •Henry P. Smith y Town Hall John B. Tuthill v- ��i 53095 Main Road William G.,.t. bertson y p� P.O Box 1179 T6leph6ne (516) 7654892 �.( �►'�+ Southold; New York 11971 Fax(516)765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 2%, ..1993 Lawrence Marks 305 .Private 'Road ,#3 Southold, NY .11971 RE: SCTM #1000-70-6�12 Dear Mr.. Marks: . The following action was taken by the . Southold Town Board of . Trustees at' the regular meeting on July 29, 1993:. RESOLVED that the•'Southold Town Board of Trustees grants an amendment 'to permit #2074 to turn float (12! X 61 ) -around so that its long axis will be in line with the faxed structure as Der original permit. If you have any questions, please do not hesitate to contact this office. V truly yours, .�. 77 John M. Bredemeyer, III President, Board of .Trustees JMB:jmd : '�.In+>: � <'1 /F.N. �� •., �6 } Y�' 0. �. �'y�' Y P iy..'. Y ..rMY�4?. . ,,;/ :. :.� .t — — _/:•, q+'"•'a�«r � w'.*�?rit%�"'.•r'^ ,r� .. '` .- vw"�.a�s e• ...'P�"d"e^�tJ^7�'.n°SN,..� �V `N, . / ,.,\' :,��,,�Ci��e� �'.'_—__'Y.s �aa,:_�.,::u�_.rerE "�ir:.,..'�i'�O=':':_-$..�.�.s: .��'�} `•rn:;; ir. .1 ; A `Baal f o t of Tow' ' T s s t F:. ow u tee �x SOUTHOW, NEW YORK �'► r Mooring No. N/A r y f - PERiv1tT:-NO' ........::?0'�:4: .: DATE: Sept. 25;." 19a _ : ^a K. , y ate. once:: Ndarks . s Ott 'q► . y�* •�h'• a', .,r n • .......... .. .E. Hai.. r: '. #; C1i w gi p. �:•.L,a3;►s�:'f; '. ~--' f. .:Yo -°�f5��•�``and.,Cfia%'te 4 p - ': �' �r. � �::: Q4•o�t�i�=.,:laws:�Q#�:�1'ie:��''� ���'• .. .... ..::: • , .. �:e`�i� e:;"S iCl:Tow �c� .. i ,� E trtfe�d ' E ULi4 �[ f�+; f1 714 :�RLAC11 fG::pF 438 RUCTION a '�N;ANDk: � TQWN, fiAP,pTERS.;AND P•UBLI ,.NDS. and:°;tf 7: ftEtiiOY L ; }F rSA Gl 4V 1 OR OT IEf `NJA I tits ,FRCi WNW ER Tt� i� 1il�AT a :irr..;e�c�rdan�e :wifh:;bite:: R6o1dt1on of The$oari� ado fed':at.a meeting held.+on' Sept. 2'S ) 1 .0 ;aid in co�i;irierat�an�af the`•.surri of $ 5 �� paid � z �" `�' � Lawrence Marks x t; ............................................................ .'........................ s. O Southold l f :.. :...:..............:................. :.......,�.. N. .Y. :and,sW�lect:#Q.rtie; i' s Terms and Conditions listed. 'on.:: fhe• %revprse':.v.si�e, :6iiedi<:.. .. of Soutlt old'' own:l'rustees' authorizes ar�d perrn�#s-fe .fallowing '' Application epprovec7.:'to-..secure a, permit. uride F the Gran fat Or. Clause:..for a::dock Ijockey: x: Y, :Creekx Southold all .in accordance.,With the- a lication. submitted. all inac�or46nce .With the detailed specifications ;as presented' iiv;' r fhe o h fih'g .application. i .r 1N`.WITNES5 WHEREOF m .' ,. . ,,•The said Board `af:;.Trus�hees°,,hire- =` causes its. -bi orate:Seel .fo.be affixed,:' Zd..tFtese: reseh#s"to... bey subscrib®d'.;by.a rhajori#y of.th rl: as is ate ; k R•{? . . . 4Vti� �>ry�,�\•:N=fi. tk�3/n y ..�tR• 11 .�Fy£���� i jF3jj�,fir, �`� r' R r .� .6� ?�:�''R �5e��,• � -„'' Y Please tear off.and .return to the Trustee office.. ' - - - --r, 9" d. -.yu:iv, tie xt• '!•;1 .�:Y.rF: -SMf,S'LUFZ{:+�.�.,F:Nh:3, Zak'". I: is .. .1 :f?,> : •'t..' .vi?j:?;-`%"w#:` "8e;: I•C. .-t',;X}.,p• .. .+.5. _4 „5-r, .e.:$r.,".r.'.v.. - TERMS and CONDITIONS The Permitter Lawrence Marks ' residin at Pine Neck Road, and Oaklawn Ave, -Southold N. Y- as g . � .pd1i•"LYf"tne cunYiti2t'af7lou'i�r'.itfib.ix�litihic 61:''iiuo cetriLiL u`up'Vit�itcaiauET.atits,�puur i�`::ic'.••isi-. •• • lowing: 1. That the-Trustee.Permit.most be prami nently displayed on:the premises effected thereby.during.the period of work-underc the permit. 1. That the said Board.of Trustees..and the-Tawn of Southold are released from.any add- A damages, or-claims for.damages,'of snits arising.directly or indirectly as a result of any oper;- ation performed. pursuant -to this permit,'.and. the said Permittee.will, at his or her own-expense,' defend any and all'such idis.iuitiated by third parties,.and the said'Perhnittee assumes-full Inability ' with respect:thereto, to the complete exclusion of the.Board of Trustees of the Town of Southold 2. That this Permit is valid fora;period of `: 12 mos., whidh is-considered to be the : .. estimated time required to complete the work.:involved, but should circumstances warrant,:regaest : for an extension may be made to the Board at a later date. i -: 3. That this Permit should be retained indefinitely, or as long as the said Permitter wishes: to maintain -the structure or project involved, to provide evidence to anyone concerned that auth orizatioa was originally obtained. 4. That the work involved will be subject to the inspection :and approyal' of the-Board .or - its agents, cad non-compliance with the provisions of.the on hating..application,may.be cane for revocation. of this Permit by resolution of the said Board. 5. That there will be no.unreasonable interference with navigation as a.ie*h of 11ie work.. ..herein authorized: 6. That there shall be 'no interference with the right of the public to pass and repass along: the beach between high and low water marks. _ 7. That if future.operations of the Town of Southold require.the,removal and/or.alferarigas in the location•of the work herein.authorized, or.if,'in the,opinion of die Board of.Trustees,line work shall cause unreasonable obstruction to free navigation, the said Permitter will be requnted upon doe notice,to remove or alter this work or project herein stated.-Without expenses to-the Towa of Southold. 8. Thar the said board will be noted by the Permttee.oi'tlie:completion.of the.work sixth-:' . 9. That the Permittee will obtain all other permits cad.copseuo't4it'=y be required:sap plemental to. this permit which may be subject to revoke upon failure.to obtain.same. (See tear ofF sheet.) MIR.. 2 5'': .'�..:�:.,Li .+, !:A'•' *rat{Y,.-.. Name of Creek: �05 cow IL TELEPHONE (516):765-1892. BOARD OF TOWN TRUSTEES TOWN OF'SOUTHOLD Town Hall, 53095 Main Road " P.O.Box 728 Southold,New York 11971 - GRANDFATHER APPLICATION - 1. Name, of' Applicant: 2... Address of Applicant: jlrarl�� �� • ! .. :.�l F N cCj 1�; 4- 0 kt; �n J 7'�+l.�b .3. Telephone Number: i$�� 6(� � �Ijb 4. Year of Construction: /j:r f `�epf s ^•a 5. Sketch of the work 'including sizes: G. Mark off on the map attached, .where your property is located using an X. Signature Please note that there is a $5.00 filing fee,- which is a one time fee, for this application. Mooring Applications-- $5400 Application Fee and a $5.00 annual renewal. fee each year. fair FRANK A.KUJAWSKI,JR., President . TELEPHONE AL.BERT J. KRIJFSKI;JRr,Viee=Ftesideut J- (516)705.1892 JOHN M.BREDEMEYE.R, III JOHN L.BEDNOSKI;,JR. . ITENRY P;SMITH. . BOARD OF TOWN TRUSTEES. TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 May 27, 1988 Mr.. Anthony 'Toy 409 .South Street Greenport, New York ' 11944 . Re:. Lawrence Marks - Amendment to Permit No. 2074 Dear Mr. Toy: Your recent request to amend.the above referenced permit .has been reviewed at the Trustee meeting held on May 45, 1988. your::request.has been:. ap:proved._by -resolution, Adopted .at this meeting, for the addition of 12 sq. ft.-On to the existing dock on the property. This letter-j's an.,amendment. to .the..'original per.niit:.and as such, shall be attached thereto: All other terms and conditions remain as written in the original permit. Very truly yours, -0 Frank A. K javvski, Jr. President Board of Town Trustees FAK:ip cc: Bldg. Dept. file Lawrence Marks S NO.— ` k � FP6EC.�— WiCH —I1NE Q.- 4iD ! 31 a PD. y �t •� �..♦ n\ 28..\ --- — i' + ° � � rmm taoot �•l \ DBw� ZZ � Mzt T NOFaOU = oz.zBpt z ma ,R. �\ ♦ S fw m ( .b @z tAHq tic) ny`Ic) n ro a5a ' fit¢'. 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Main Road P..O.O.Box 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer CAI ® OQ Telephone(631) 765-1892 Michael J. Domino O Fax(631) 765-6641 com E C r L� ---------- BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD OCT _ 3 �.13 j .,Gtltri';li; ,r APPLICATION FOR A TRANSFER OF A WETL RMIT DATE _ 1 OWNER LuGi -el rr i S PHONE ` /7--7 S 3—L111. y MAILING ADDRESS Z AGENT PHONE ADDRESS PROPERTY LOCATION 30 5- P�_o ja�a TAX MAP NO. / ID �° I I I I/We v CQ' request a Transfer of I Permit# • from -Gt(,CVZlncy_ /�'{OlV1 it I i Signed By: zu c � I i J 1 James F. King, President ~QF SOpry Town Hall Annex Bob Ghosio, Jr., Vice-President 54375 Main Road ~O P.O. Box 1179 Dave Bergen 41 Southold, New York 11971-0959 John Bredemeyer y Michael J. Domino • O Telephone (631) 765-1892 ~~yCOU'~~ Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE #0857C Date: May 17, 2013 THIS CERTIFIES that the 4'x42' catwalk: 3'x12' ramn• 6'x12' float in an "I" configuration At 305 Private Road #3- Southold New York Suffolk County Tax Map # 70-6-12 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 9/1985 pursuant to which Trustees Wetland Permit #2074 Dated 9/25/85, was issued and Amended on 8/2/93, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the 4'x42' catwalk: 3'x12' ramp• 6'xl2' float in an "I" confi uration. The certificate is issued to LAWRENCE MARKS owner of the aforesaid property. Authorized Signature James F. King, President ~~$yfFr'((,rC Town Hall, 53095 Main Rd. Bob Ghosio, Jr., Vice-President ~d& P.O. Box 1179 Dave Bergen Southold, NY 11971 John Bredemeyer TO Telephone(631)765-1892 Michael J. Domino f~ Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD d 3 DATE OF INSPECTION: 7A-0-5- 1 1~ 7-4 ? Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction /'Y2 constructed ? Project complete, compliance inspection. INSPECTED BY: I COMNTS: d,C CERTIFICATE OF COMPLIANCE: J. KEVIN MCLAUGNLIN • • Attorney At Law Telephone (631) 765-6085 Winds Way Professional Center Facsimile (631) 765-1856 44210 Rt. 48, P.O. Box 1210 Email ikmclaw woptonline.net Southold, New York 11971 May 10, 2013 Southold Town Trustees Southold Town Annex Southold, NY 11971 Re: Lawrence Marks Premises: 305 Private Road #3, Southold, NY SCTM #1000-70-6-12 Dear Trustees: Request is hereby made for a Certificate of Compliance regarding dock permit No. 2074, as amended on August 2, 1993, copies of which are enclosed herewith, along with my check in the sum of $50.00. Ve y y s, evin Laughlin Encs. Hand Delivered i~ BOARD OF 'TOWN TRUSTEES 3 ~ ~ 3 3• ~ 1 TOWN Or soU'r11OLD No 53095 I&W Road Phono 765-1892 1 Southold, N. Y. 11971 l~.dc ,2 19 RECEIVED OF, ~~~y~ a Dollazs f / OZ~ c C-ti For L~ BOARD OF TOW' 'TRUSTEES u~L Cash Check ? .~.~.~.•.~.~,°'~'~+}rte TRUSTEES O~gUFFOC~-C SUPERVISOR John M. Bredemeyer, III, President OG SCOTT L. HARRIS Albert J. Krupski, Jr., Vice President 'yam Henry P. Smith ,°n < Town Hall John B. Tuthill T 53095 Main Road William G. Albertson P.O Box 1179 Telephone (516) 765-1892 Southold, New York 11971 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 2, 1993 Lawrence Marks 305 Private Road #3 Southold, NY 11971 RE: SCTM #1000-70-6-12 Dear Mr. Marks: The following action was taken by the Southold Town Board of Trustees at the regular meeting on July 29, 1993: RESOLVED that the Southold Town Board of Trustees grants an amendment to permit #2074 to turn float (12' X 6') around so that its long axis will be in line with the fixed structure as per original permit. If you have any questions, please do not hesitate to contact this office. V9qy truly yours, M 61 John M. Bredemeyer, III President, Board of Trustees JMB:jmd T :_4 c SRI` z p n - i d. :Av~~ r!~P~~r r'Y "?~i`.'~,rvr ~a ? '"tom' L a~ - Board Of Southold Town Trustees ik-A y ~ " SOUTHOLD, NEW YORK 'i Mooring No N/A PERMIT NO... 2.074:. DATE: Sept. 25, 1985E U ~ e .4Q,.i. !rzi !",n t n Lawrence Marks r' Pursuant' to -the provisions of Chapter 615 of the Laws of ' the State of New York; 1893; and'Chapter 404 of the Laws of the State,of,' New York -0552,,' and the Southold Town Ordinance ea- titled`,""REGULATING AN[ THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LAUDS and the REMOVAL ,OF SAND" GRAVEL OR OTHER MATERIALS FROM, i ifs f LANDS "UNDER TOY N WATERS;"'and `in aceardance with the Resolution of The Board adopted at a meeting held on Sept 25, a ~ 1985 , and m consideration of the sum of $ 5 ....00 . paid by I $ Lawrence Marks L. Southold F ' of N. Y. and 'subject to the sy TF Terms and Conditions listed on the reverse side hereof, of Southold` Town Trustees authorizes and permits the following: ` IV Application approved to secure a permit under c~ `Iz the Grandfather Clause for a dock in Jockey 4 U Creek, Southold all in accordance with the application submitted. all in accordance with the detailed specifications as presented in. gry i the originating application. IN WITNESS WHEREOF, The said Board of Trustees here k by causes its Corporate Seal to be affixed, nd these presents to be subscribed by a majority of th s and as f his ate. M s„ 000 y A ~ ir'„+~~ :alp T .lk 1 l~l TrusJ a ~ L zc. / ~ r ii trite} 4 ~ Please tear off and return to the Trustee Office. TERMS and CONDITIONS The Permittee Lawrence Marks residing at Pine Neck Road, and Oaklawn Ave, Southold N Y as w .parr "of me -comideradou lur LL1C.Yli4iltile ol.:Lv Perabit uuW UituGa>l6llt1 6114 lJ1G.lYaUC tV auc lowing: 1. That the Trustee Permit most be prominently displayed on the premises effected thereby during the period of work under the permit. 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any oper- ation performed pursuant to this permit, and the said Permittee will, at his of her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold 2. That this Permit is valid for a period of 12 mos. _ which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that auth- orization was originally obtained 4. That the work involved will be subject to the inspection and approval of the Board or -.its agents, and non-compliance with the provisions of the originating application, may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along, the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required,' upon due notice, to remove or alter this work or project herein stated without expenses to the Town of Southold 8. That the said Board will be notified by the Permittee or the completion of the work auth- orized. 9. That the Permittee will obtain all other permits and consents that may be required sup- plemental to this permit which may be subject to revoke upon failure to obtain same. (See tear off sheet.) x ! 1. MM I rev. 3128}88 BOARD OF TOWN TRUSTE988 CREEK e = Town of,S,outhold 9 Main Road YOUR ORIGINAL PERMIT, NUMBER Southold, New York 11971 ~2 GLf_ 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. 1,0P3, JCS ..~PWIIIAI:/ 1. Applicant's Name & Address:. Wl~<. f~../.4 a1........... cc~~ .....-.....Tel. No.?~J._::~?.1 2. Contractor's Names & Address: , L!~/.1. GEC ^F..~ . - . f 7- 1 CA 2-9, 1 . . Tel. No'1.77: I ,7.7 . 3. 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 1987-1988 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) . 1, 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. PERMIT NUMBER Signed - Owner Sicrned - Contrar-tnr Fi im raw O S"Im A-I it ~®V ~ s Fe971 'kh FRANK A. KUJAWSKI, JR., President a TELEPHONE ALBERT J. KRUPSKI, JR., Vice-President (516) 765.1892 JOHN M. BREDEMEYER, III JOHN L. BEDNOSKI;: JR. HENRY P. SMITH... BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 May 27, 1988 Mr. Anthony Toy 409 South Street Greenport, New York 11944 Re: Lawrence Marks - Amendment to Permit No. 2074 Dear Mr. Toy: Your recent request to amend the above referenced permit has been reviewed at the Trustee meeting held on May 25, 1988. Your request has been approved by resolution, adopted at this meeting, for the addition of 12 sq. ft. on to the existing dock on the property. This letter- is an amendment to the original permit and as such, shall be attached thereto. All other terms and conditions remain as written in the original permit. Very truly yours, h~- Frank A. Kjawskl, Jr. President VV Board of Town Trustees FAK:ip cc: Bldg. Dept. file Lawrence Marks i9 67 7 x 11)4 ~o WRAF 3` F/cai 0 - s~~- ~~s~ s~ GUS fl-a s~-- y Ad~dm -4 C sit Y. r w 1 t "n^ t JS 0 im, ~ p r y nir O: 71 r x °l 4.4 0 Zr mom i S 1 tr , Y. } Y _ r 51 ~w 3 p 70I t o z ~ "COO H 2 e a~ ~ Name' of Creek V3 TELEPHONE (516)765-1892. BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 GRANDFATHER APPLICATION (c 1. Name of Applicant: L aC-t C-C-- 2. Address of Applicant: J-r°'.ry I-C-- t - ,st~rN {,eO< . 1'f mrz 3. Telephone Number: O O v 4. Year of Construction: GE C; Sv Y&N s ^t 5. Sketch of the work including sizesp:, dt/fiM 40 Y: V': ev 6. Mark off on the map attached, where your property is located using an X. Signature: Please note that there is a $5.00 filing fee, which is a one time fee, for this application. Mooring Applications- $5.00 Application Fee and a $'5.00 annual renewal fee each year. ~ ~~FFilt,~~® TELEPHONE (516) 765-1892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 CREEK STRUCTURES INVENTORY L&w r4 Y1 C2 ~ ~nrk5 Current Owner's Name: ' Index No. Address: ~1us1~I1~U , rv`l t ~3SS Creek: Joc- CQeq Purchase Date: i Telephome,-No . ~'od ::Fi-ea oT '7- r Previous "Owners: 2Q k-2Y Permit Applicant: Permit No. Permit Specifications: Specifications Found: d ~Y l(~ 'vwt y- rry -X LO (td 0-4 red k4 Condition: Comments: spj"- C S e~ l-