HomeMy WebLinkAboutCASE, RUSSELL B~ ~ue~ to a ~ of 3 ft. in ~der ~ ~tain ~erlal t~
rain water ~rryi~g
NO, 1
TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ................................ 19 .... Application No ...................
Approved ............................................ 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 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 o~
the premises and available for inspection at all times.
E. Applicant shall notify the Board of Trustees upon completion of the work covered by permit.
APPLICATION IS HEREBY MADE ro 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 wamrs of Town of 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 liability and damages of any kind.
~ame o~ Owner of Premises ....... .~. ,.. (.-(....d..~.X. ?....~. ~ .TT., .................................................
Street Address of Proper~y ........ ~.~. ,~'..~.~.".5'....~...~...,~'..~. .... .~...~. ?. ?...~..~. 2~..~..~..--. ...........................
Home Address If Other Than Location ......................................................................
Creek, Bay or Harbor Fronting Property .... .~.o..w..7. ~..~,~ .... q..~.~......Mr..~..~...C~.~.~, .~,~5' ...................
Permits Requested To: . .~..~. ~.. ~:.,614~,~X dj ~. ~...'~...o-.~.~,~P...~ ~..~ ~. (.~...~m.. ~...~.~..~! .~. (-&...~'J'~.4~. ~. .......
Size of Proposed Work: Length'~ ..... i/-~' t..~??. *gidth ............ Heighth Above High Water ...~.~..~.~..~. ~.~.~.~'~
Depth Below Low Water .~'o~C-/)~-~-~ C. - Average R~se_ ~ ,~ _'t";5 _In T~de ............ : Yards m Be Excavated ............
Width of Canal, Creek or Bay Fronting i)roperty~.Q,r. .?~.../j./.~.?.c.~.~..~..~'.~.~..~. Depth at Low Tide . .~./.~.~ .r.~..,~..~..'T../~.'
Is This For Private or Business Use? ....... .~.~.~../~. ........................... Area Zoning .~..~.~..'~.-- ............
Complete plot plan to be drawn on reverse side of this application.
STATE OF NEW YORK )
)s.s.
Stoan a Ih described
· '- ' ............. ' ' ' ' ' · the work
will be done in the manner set forth in the application and as approved by tlCe Board of Trustees of the Town of
Southold. and the applicant agrees to hold the Town of Southold and said trustees harmless and free fi:om any and
all damages and claims arising under or by virtue of said permit.
Sworn tobeforemethis .../.~...~,. ..... day of ~.~... 19..~'.?.
N~otary publ~~......~.~....~...~.'~. ................. County of .~~..
~ARION A, REGENT
NOTARY PUBLIC. State of New Yor
No. 52-3233120 Suffolk Count
Tsrm [xpires M~arch 30
FOEM NO. I
TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ................................ 19 ..... Application No ...................
Approved ............................................. Permit No ............................
Disapproved a/¢ ............................................................................................
..................................................... chairman, Board of Trustees
APPLICATION FOR PERMIT
INSTRUCTIONS
A. This application to be completely [illed 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 issuat~ce of a permit.
D. Upon approval of this application, Town Trustees will msue a permi~c to applicant. Such permit shall be kept on
the premises and avaiIable for inspection at ail times.
E. Applicant shall notify the Board of Trustees upon completion o£ the work covered by permit.
APPLICATION IS HEREBY MADE to the Board of Trustees of the Town of Southold, Suffolk County, Ne~v
York, for the issuance of a permit pursuant ro the laws. Ordinances and regulations governing construction of: docks,
piers, bulkheads, jettys and dredging in, under, and over the wa~ers of Town of 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 liability and damages of any kind.
Name of Owner of Premises ....... .~..-...Ag/.:..~.~.~...~....~..5.?~.: ..................................................
Street Address of Property ........ ~/~.'~.. ~.~ .... ~ ~.~.~.~.~ ............................
Home Address If Other Than Location ......................................................................
Creek, Bay or Harbor Fronting Property .... ~e.r E ~.~. .... q ~.. ~. ~. ...................
Permits Requested To: . ~. ~4~.~. · ~...~..~.q~ ~(~..~(~r~..~.~ ........
~ ~ pro~ose~ ~or~ ~ ..... ~o ....... '%~ ~ ............ ~ ~o~ ~ ~r ..............
Depth Be ow Low Water ~.~ . A~erage ~ise In Tide ............. : Yards to Be Excavated ............
Width of Canal. Creek or Bay Fronting ~roperty~O~. ~.~49~ff~.~ Depth ar Low Tide .~.~ F.~ ~.~,~. A*
Is This For Private or Business Use? ....... ~ ........................... Area Zoning ~&4~ ............
Complete plot plan to be drawn on reverse side of t~is application.
STATE OF NEW YORK )
)s.s.
COUNTY OF )
............................ being duly sworn deposes and says that he is the applicant for the above described
permit, and that all statements contained herein are true to the best of 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 applican. 3.agrees to hold the Town of Southold and said trustees harmless and free from any and
all damages and claims arming under or by virtue of said permit.
Sworn to before me this .... .... day of~.'T~...~¢.... 19...7..~.
FOII~I NO. !
TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined .............................. 19 ...... Application No ..................
Approved ............................................ Permit No .............................
Disapproved a/c .............................................................................................
....................................................... chairman, Board of Trustees
APPLICATION FOR PERMIT
INSTRUCTIONS
A. This application to be completely Hlled in by typewriter or in ink and submitted ro the Town Trustees in dup-
licate.
B. Plot plan showing location of lot and buildings on premzses, relation to adjoining premises, public streets,
parks, etc., and giwng 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 ~ssuance of a permit.
D. lJpon approval of this application, Town Trustees will issue a permit ro 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 of 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 liability and damages of any kind.
Name of owner of premises ......... ..~.~...~.'..&..~.~. i. &?..: .........................................
Street Address of Property ......... .~....~.7...'J-~z.. ..........................................................
Home address If Other Than Location ........ k~.~ .dL%~.-.t..~.~.'. .....................................
Size of Proposed Work: Length ..... '.~.' ....... Width...~......~.( .'..Heighth Above High Water.~.~C~..d'.~
Depth Below Low Water ...... .~.. [' ...... Average Rise In Tide ..... ~ ~.~ .... Yards to Be Excavated...././. ~ ....
Width of Canal, Creek or Bay Fronting Property, ..~].~'.; .Z.~...Depth at Low' Tide ._~~.
eusin Use~ w~/J/z~-~ ~ ~*~-~*-¢- * Zoning .... ~~ ..........
Is This For Private or ess ...... ~ ............... ~,. ........... Area
Complete plot plan to be drawn on reverse side of this application.
STATE OF NEW YORK )
)S.S.
~ ~(7 r/~COUNTY ~if' ' )
scribed permit, and that all statements contained herein are true ro the best of 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 Sonthold. and the applicant agrees ro hold the Town of Southold and said trustees harmless and frec from any
and all damages and claims arising under or by virtue of said permk~
(applicaut)~
Sworn to before me this../, .~., .~ ..... day of.~,/~... ~9..G ~..
Notary public ~~ounty
F~o, 52~7057~50
FORi~ NO. 1
TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD, N, Y.
Examined .............................. 19 ...... Application No .................
Approved ............................................ 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 dup-
licate.
B. Plot plan showing location of lot and buildings on premises, relation to ad]oinlng 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 all 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 applicable laws, ordinances, regulations and conditions specified By said trustees, and to hold
the Town of Southold, and ail Town officials free from liability and damages of any kind.
Name of owner of premises ....................................... · .......................................
Street Address of Property .. .~.~ ................ ~ ...................................
Depth Below Low 'Water ...... 3'. ....... Average Rise In Tide .... ~D:~.: ..... Yards to Be Excavated .... /..? .....
'vVidth of Canal, Creek or Bay Frontin~ Property ...... .~0~,, .~.~f. .... Depth at Low
Tide .. ~ .,~ ...........
Complete plot plan to be drawn on reverse side of this application.
STATE OF N~W YORK )
)s.s.
COUNTY O~ )
~--x~-,~...'~.'.~ ? ....... being duly sworn deposes and says that he is the applicant for the above de-
scribed permit, and that all statements contained herein are true to the best of 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 trustees harmless and free from any
and all damages and claims arising under or by virtue of said permit.
(applicant)
Sworn to before me this ..... /.~, ."~...day of ,.. 19~ ....
Notary public . nty . . .
Nc, 52-7057 ~.50