HomeMy WebLinkAboutTR-250 TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
PERi'IT NO..,.,~..~.0.. .........
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 .... ~.~,~,,~..~.. ~,D.~.~. ................ and in consideration of the sum of
$....~.7..~., lawful money of the United States, paid by ....... ~.~...~...)L~'~.~ .................
residing at ......... ..~...*q~..,g~..~.~...~..~..~.....~...~.~..e..,.~...~.~..~.~.$.~.~.~.., ......... New York,
the said Board of Trustees of the Town of Southold, Suffolk County, New York, hereby
authorizes and permits said .................... ..~..~..~.~...~q~ .......................................... to
The said ........ .~.e.....~..~....~..,~.g.~ .............................. , as 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 or as a any operation on pursuant to
directly
indirectly
this
permit, and will at his own expense, defend an y rend all suits which may be brought by third
parties os 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 Board 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 ye_ar above written.
............................................................ (L. S.)
STATE OF NEW YORK )
SS:
COUNTY OF SUFFOLK )
ON THIS...~.Q~ ........ day of ......... ~t~%~ .................................... t9~.~..., before me
personally c~peared ~a~on$ Dean, Frank Dawaon,
all personally known
to me, who, being by me duty sworn, severe lly said that they each resided in the Town
of Southold, County of Suffolk, State of N~ York, and were members of the Board of
Trustees of said Town of Southold ~nd constituted a majority of the ~me; that they
knew the corporate seal of s~id Town of Southold; that the seal affixed to the foregoing
instrument w~ such corporate seal; that it was so ~ffixed thereunto by order of the
Board of Trustees of said Town of Southold and that each one signed his name thereto
~ Trustee and by like order,
~ ~ ~oto~ Public
FOP~I NO. 1
TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
TO~IN CLERK'S OFFICE
SOUTHOLD,
~.xa,mined .._.~.~-~ .~.. ....... ~.. 19.~.~. ~pDlioalioi~ ~o
.....................
D'fs~pprove~a,/c ................................................................................................................................................................................. ] ................................................................
~.....t%..~ oh~a~, Bo~ o~ ~ees
/ eeUCAT,0N
A. ~his ~p~lic~ion to be oompl~el~ filled in
B. Pl~l plan showing Ioca~ion o~ lot aad bu~din~s on p~s, relation ~o adjoinin~ premises, public s~ree~s,
parks, etc, and g?~ng detailed de.~cz~p~ion o~ proposed le~yo~ o~ project must b~ ~'~ o~. dia~am w~ch is p,~ of
~his a~pHc~iio~.
C. Thc work covered by ibis a~pHcal~on may no~ be commenced before the issuance of a per~t.
D. Upon approval of this appHca, tion, Town Trustees w~ issue ~ permit to ~ppHcamt. Such permi$ sha~ be ke~t
on the premises and avaAlaBle far ~spection at aH i~mes.
E. AppHcan~ sh~.E notify the Board of Trustees upon compaction of the work covered by pemit.
~PLIGATIO~ IS Z~E~EBY ~ADE ~o the Boaxd of Tr%~stees o~ the Town of Bo-aihold, ~folk ~o~iy, New York,
for ~he issuance of a pe~i p~sa~ to the ~aws, Ord~a~nces a~d regvda~lions governing consiruciion of: docks,
piers, bu~ea.ds, jettys and ~e.d~ng h~; under, and ever the waiers of To~ of ~ou~old. The appHc~t agrees
to co~ply xwSih a~ applicable laws, or~ances, re~aiions and con~tions specLfied by said ~rustee.s~ and l,o hold
~he Te~wn o,f ~outho~d. and e~H Town o~cials free fro~ ~iabi~y and damages o.f a~ny ~d.
<.~ .................... ~ .................. ~....... , , ..-----.~; .............................................................................................
S~ee~ A~ess of Pr'~per,~ ....~~. ~:.~ ........ L ~_._.~:~[~ ......................................................................................................................
ome .............. .....................................................................
/~ ~ ~ ~9 / ~ ? .......................................
.......... .........................................................
Permi~ ~equesSed ~o: ..................................................................... . ...........................................................................................................
Siz~ of Proposefi Work: ~e~h ................................. Wfdth ................................. ~ei6~h Above ~i~A W~er .,...:~...] ...................
De~h ~elow ~ow W~$ez ............................. Average ~ise ~n ~ide ................................. ~ds ¢o Be ~c~a~e~ .................................
Wfd~ of Oan~l, Oree~ o~ B¢~ ~ro,n~i~ Proper¢~ ............................................... ~ep~h ~ ~ow Tide . ..................................................
Is ~i~ For P~v~e or Busi:ess ~e? .......... ~.~..~.:.~ ........................ Are~ Zonin~ ...........................................................................
Oompl~e pIe~ plan ~o be ~ra~ on reverse side of ~is ~pplic~ion.
~AT~ ~F ~VJ YORK)
so~bed ~er~t, aad th~ ~1 s~,e.me~ts contained he~e~ ~re t~e to the best of his knowledge aaa be~ef;
w~rk ~ll be done ~ the, manner set forih in the sppHcatio~ a~d as a~proved by the Board of Trustees o~ the Town
of ~ou~hold, a~d lhe a~pEoaat ~ees ~o hold the To~ gf So~thold and ssid trustees hornless and free fro~ any
and aH damages ~nd claims ~sing under or by vi~ue of said per~it.
~warn to be~ore me thls~.......~.~.~ ....... a~y ~ ....... ~.~ ............. 19._....~:.
f~ ~ ~ ~ ~ic, State of Naw
' ~ No, 52-3889685
~ua ffied i~ Suffo ~ County
~ission Ezp res March 30,