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HomeMy WebLinkAboutTUTHILL, BURNETT F~he ~live~y ~oof~ t~ ~eip~ ~~f ~ ~meby duly TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES PER,MIT NO ..... ~.4,~ ......... 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 accordance with the resolution of the Board of Trustees of the Town of Southold adopted at a meeting of said Board on ......... ~®...6~...I~6~ ........................ and in consideration of the sum of money of the United States,~ by ....... 'B~n~'"~h'J:~]: ............ residing at .......... ~..tg~...~.,.~.,.~.~,.~*: ................................... New York, the said Board of Trustees of the Town of Southold, Suffolk Count, New York, hereby authorizes and permits said .... ~e~..~~ ...................................................... to in fill ~om th~ ch~nel at B~a~at~=~ Roa~, a res~oration ~f original ~rmit The said .............. ~;~.~,,...~¢,h;Lll ...................., as part of the consideration for the issuance of this permit does hereby release the said Board of Trustees and the Town of Southoid from any and ali damages, claims for damages or suitsthat may arise or occur directly or indirectly as a result of any operation carried o.n 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 unreasonable interference with navigation as a result of 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 beach between Iow and high water mark. 3. That the work shall be subject to the supervision and approval of the said BOard of Trustees or its agents. IN WITNESS WHEREOF, the said Bcord of Trustees of the Town 'of SouthOl~l 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 ...... k.S.) .... ~..~..=.~7.: ........... : .... :....( . s.) STATE OF NEW YORK ) SS: COUNTY OF SUFFOLK ) ON THIS ...... ~:~,~ ...... day of ........... ~11~. .................................... ]9.~G.., before me personally appeared /~l%~a~ ~o ~01~.~, F~a~]¢ Da~/~o~, J01~ F. M~1~lty~ O~org~ ~/~i~0~ and Dougl~ RO~tson~ all personally known to me, who, being by me duly swo. rn, 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 seal; 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 ~OT^R¥ P~JBLJC. State o~ New York Bo. 52-323~,12~8 Suffolk Oountz FOR~I NO. ! TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~ ~ :o ...................... ~ .... ........................................... ...... : .... ' ....... FOR PERMIT INSTRUCTIONS A. This application to be completely filled in by typewriter or in ink and submitted to the Town Trustees in dup- licate. 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 project must be drawn on diagram which is part of this application. 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 ali 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 o~ Southold. The applicant agrees to comply with all applicable laws, ordinances, regulations and conditions specified by said trustees, and to hold the Town of Southold, and all Town officials free from li~ffty and damages of any kind. Name of owner of premises . ~.~..~./.T.~/. .~..~...7~.......~.../..O. ~...~..'/..~...Z_~.. ...................................... Street Address of Property ~..Zf~..~.. ! .A<.' .~. ~...~/~..& :/~.~. ~ ./.~.~X 3. .-X .~...~.,..~. ¢'.'7:.~. F/?.~.~.q .~...27. (: ............... Home address If Other Than Location J.~.~.4/.~. .~..~q'.'~..'q.: · ~ ~..~-t/-'-~/~ A&2Y-5..~..~. :~ .......................... ............ . ................ Permit Requested To: .ff.~.z~5.~. ?..Z~...~.~.. ¢. >/,4~./<9'. ~¢,~.:~.~74r.~.-44 .~~ '.~..'-:. · ./.~. ~ ./TA~,.E.~7..~/:.: .~/K..; .... h ~.: & ~ f ' W~dt~~. ~ ~ Heighth Above High Water ~;> z2~7 ~ Size of Proposed Work: Lengt ~ ~...~ ..... ' '"~ ................. ~"'L"'_ Depth Below Low Water .... ~.. ~. ........ Average Rise In Tide...~././.~ ...... Yards to Be Excavated~.~.~¢~.~.l/..Jr...~..~F~ Width of Canal,~;~r Bay Fronting Property .... /..~.q'/(. ~ ......... Depth at Low Tide d?...~',~?~../. :./.f: ........ Is 'This For Private or Business Use? ......... /: ./~.4~. ~.'. .Area Zoning .......................... Complete plot plan to be drawn on reverse side of this application. STATE OF NEW YORK) ) S.S~ ,,t~ ~,~t~'*~ '~ -~/~ ~/~COUNTY~'~')' ~~...~:-.>..~.tL~:~being duly sworn deposes and says that he is the applicant {or the above scribed permk, and that all statements contained herein are true to the best o~ his knowledge and belief; that the Work will be done in the manner set forth in the application and as approved by the Board of Trustees of the Town of Southold, and the applicant agrees to hold the Town of Southold and said trustee~ harmless and :tee ~rom any and all damages and claims arising under or by virtue of said permit, ' Sworn to before me thls..,..,,,,..,.. ~F::D w,day°f' :~ :~:_~::,~. . ... 19.~~.... (applicant) ~qTXRY PUBLIC, State o~ :e~ Notary public ........... :. · ,a~sla,~s ~ c~ ................