HomeMy WebLinkAboutTERRY, RAYMOND W JRTOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
PER,AlT NO .....................
Pursuant to the provisions of Chapter 615 of the Laws of 1893 of the State of
New York and Chapter 404 of the Laws of 1952 of the State of New York and in occordonce
with the resolution of the Board of Trustees of the Town of Southold adopted at a meeting
of said Board on. ........ ~9,~..~.$.~.....~.D.~...~. ........................ , and in consideration of the sum of
$..~,.~..*.,~.~.., lawful money of the United States, paid by ..... ~.~....~...$~?..~...~...~.~,.~.0..~.~....~..~."~ ' '
residing at ..... ~T~3g~,~...{~.$~k ~;~4,~.~ ~~.~, ~e~y~ ~o
.... , New York,
the said Board of Trustees of the Town of Southold, Suffolk County, New York, hereby
authorizes and permits said.~3~ ..... ~.,~.S ..... P,~;~..~,...~'~.y.~,..J~ ................. to
to dr~dg~ I5 yds~ and an!~g~ ti~ p~es~nt do.~ to th~ lenD,h,
of 35 feet~ on Jockey ~e~k in f~on~ ~f th~ ~oper~y~ ali
The said .,~.,~...'~..~.~;~.~....~B3'.~.q.~.~...~..~...~..~.~",,~., ~ ~part of the consideration
for the issuance of this permit does hereby release the said Board of Trustees and the
Town of Southold from any and all damages, claims for damages or suits, that may arise or
occur directly or indirectly as a result of any operation carried on under and pursuant to this
permit, and will at his own expense, defend any ,and all suits which may be brought by third
parties as a result of any operation carried on pursuant to or in accordance with the terms of
this permit, and assume full liability with respect thereto to the complete exclusion of
said Board of Trustees and the Town of Southold.
THIS PERMIT is subject to the following terms and conditions:
1. That there shall be no unreascnaJ~ ~in~r~ee ~t~,~d~Jen ~sul~f~ the
work herein authorized.
2. That there shall be no interference with the right of the public to pass and repass
along that portion of the b~'l~ b~v~e~ ~ ~Ra~l~ ~te~tr~ky 6'~ ~
3. That the work shall be subject to the supervision and approval of the said Boa.rd of
Trustees or its agents.
IN WITNESS WHEREOF, the said Bcard of Trustees of the Town of Southold has
caused its corporate seal to be hereunto affixed and these presents to be subscribed by
a majority of the said Board of Trustees, the day and year above written.
/
seal
..... (L. S'i)
I ........ (L. S.)
.(L. S.)
S.)
STATE OF NEW YORK )
SS:
COUNTY OF SUFFOLK )
ON THIS.~?..~....,;...doy of ....... .~.~..q.~...~ ......................................... 19.G.~..., before me
personally appeared ~iYah ~ ~O!~i~ ~ D~o~, ~i~i~
ali personally known
to me, who, being by me duly sworn, severally said that they each resided in the Town
of Southold., County of Suffolk, State of New York, and were members of the Board of
Trustees of said Town of Southold and constituted a majority of the same; that they
knew the corporate seal of said Town of Southold; that the seal affixed to the foregoing
instrument was such corporate sea. I; that it was so affixed thereunto by order of the
Board of Trustees of said Town of Southold and that each one signed his name thereto as
a Trustee and by like order.
.... ....
Notary Public ~/
Examined
Approved
FOR~ NO. 1
TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Application No ...............................
Permit No .......................................
Disapproved a/c .......................................................................................................................................................................
................................................................................ chairman, Board of Trustees
APPLICATION FOR PERMIT
INSTRUCTIONS
A. This application to be completely filled in by typewriter or in ink and submitted to the Town Trustees in duplicate.
B. Plot plan showing location of lot and buildings on premises, relation to adjoining premises, public streets, parks, etc.,
and giving detailed description of proposed layout of proje;ct must be drawn on diagram which is part of this appli-
cation.
C. The work covered by this application may not be commenced before the issuance of a permit.
D. Upon approval of this application, Town Trustees will issue a permit to applicant. Such permit shall be kept on the
premises and available for inspection at arll times.
E. Applicant shall notify the Board of Trustees upon completion of the work covered by permit.
APPLICATION IS HEREBY MADE to the Board of Trustees of the Town of Southold, Suffolk County, New York, for the
issuance of a permit pursuant to the laws, ordinances and regulations governing construction of: docks, piers, bulkheads,
jettys and dredging in; under, and over the waters of Town of Southold. The applicant agrees to comply with all appli-
cable laws, ordinances, regulations and conditions specified by said trustees, and to hold the Town. of Southold, and all
Town officials free from liability and damages of any kind.
Name of owner of premises ....]v~.,..~c..~...8...]?~.Q~LcJ...~,...]'~.~r.~-.~...~T~ .....................................................................
Street Address of Property ..... ~,~cJ~-...Cz,.e~-..T~,~.-~e. ...................................................................................................
Home Address If Other Than Location ........ ~.¢~ ...................................................................................................................
Creek, Bay or Harbor Fronting Property ....~.Q.g~f~....~.~.~.j~ ...............................................................................................
Permit Requested To: ........... ~...-~1'. ...... ~.~.z~ ,~.,/,..~ ...... ~...~.~.~.~./........~.~._r~.. ..............................
Size of Proposed Work: Length ..~.2.l. ........ 2Q.~... Width ...~.t. ..................... Heighth Above High Water],l,~..t .....................
Depth Below Low Water ...8..~. .................. Average Rise In Tide ........ 3.~. ............. Yards To Be Excavated ...'15 ..................
Width of Canal, Creek or Bay Fronting Property ...~..5.t....t,~..]Q0.t. .............. Depth at Low Tide ..... ~D.Q~..~. .........................
Is This For Private or Business Use? ...p.~..'i .v~.e. .................................... Area Zoning .... .V..e...8.~..e.P...tc.~.]: .........................
Complete plot plan to be drawn on reverse side of this application.
STATE OF NEW YORK)
J )S.s.
COUNTY.__~ OF,
..... .~z:~.~,.~¢:.~ ......... z..:...4,~.~..~.~..., being duly sworn, deposes and ays that he ~s th~ applicant for the above described
per,t, and that all statements ~ntained herein are true to the best of his knowledge and belief; that the work will be done
in the manner set forth in the appli~tion and as apprmed by the Board of Trustees oF the. Town of Southold, and the
applicant agrees to hold the Town of Southol~ and said trustees harmless and fr~e fr~m any a~d all damages and claim~
arising under or by virtue of said permit.
........ ........... ........
.,
Sworn to before me this
Nota~ Pu~i~.~.. unt of