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HomeMy WebLinkAboutTR-347 TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES PER IT 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 accordance with the resolution 0f tFie Board of Trustees of the Town of Southold adopted at a meeting of said Board on ............ _~......~..,~......~L.~..6. ................ , and in consideration of the sum of $...~., law~l mo~ of the United Stores, paid by.....~...~.~e~..~.. resid ~g at ........ ~?~.~,...~Q~,,.~.~ ........................... , New York, the said B~rd of Trustees of the Town of Southold, Suffolk Count, New York, hereby authorizes and permits said ................ ~,...~~..~ .............................. to The sa d . W~,~., - n~:.~:f~elc~ C ~ ........... ~] ..................... ~ ............... , as partof the consideration far the issuance of this permit does hereby release the said Board of Trustees and the Town of Southald fram any and all damages, claims for damages or suits that may arise or occur directly or indirectly as o 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 <~ssume-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 shell be no unreasonable interference with nevigetion as e result of the work here~n authorized, 2. Thet there shall be no interference with the right of the public to pass end repass along that portion of the beach between Iow and high water mark. 3. That the work shall be subject to the supervision end opprovel of the said Board of ~stee~.~r its agents. ' IN WITNESS WHEREOF, the said Bcard of Trustees of the Town af Southold has caused its corporate seal to be hereunto affixed and these presents to be subscribed by o majority of the Said Board of Trustees, the day and yegr above written. :L. S.) STATE OF,NEW YORK ) SS: COUNTY OF SUFFOLK ) ON THIS.......~.~ ....... day of ................... .J....u~y. ............................ 19~.6.... before me personally 0ppeored i'~'~'~i~%~r~b. B. ~d~, .l~il, n~ ~ ~!:~ ~ ~Nult~y, G~ Simpson a~t I)o%l~las Rober~son, all personally known to me, who, being by me duly sworn, sever~ Ity said that they each resided .i~ the Town of SouthOId, County of Suffolk, State of New York, end were members of the Board of Trustees of sdid Town of Southold and constituted a majority o~: the same; that they knew the corporate seal of sakJ Town of Southold; that the seal affixed to the foregoing instrument was such corporate seat; that it was so effixe~ thereunto by order of the Board of ~rustees of said Town of Southold and that each one sighted ~his name thereto as a Trustee ar~, by like order. Notary Public ARION A REGEN~ I~ORM N0. 1 OWN OF SOUTHOLD BOARD OF TOWN TRUSTEES TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 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 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, Ne~v 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 couditions specified by said trustees, and to hold the Town of Southold, and all Town officials free from Iiab~ and damages of any kind. Name of owner of premises ..... ~.~. ;~./--,~.~..~..~[./~.'./..(~ ~.0.,~.. · .~.'T'. ......................................... Street Address of Property ....... ~.~.~/.~. ~. ,~C/f.. ~.~.-/ .... '-~.~-~'~../4(?.-- ~.~.//- ...................... Home address If Other Than Location ......................................................................... Creek, Bay or Harbor Fronting Property ..... ~f.~.~ff.~.~...~..~.¢.*/~. .......................................... Permit Requested To:../~/7~//../,,7~/~/~..~.~..~.. j~/_~7~...~..~/~.. ~2'.,~.~.. ~.~.~'.~..~_,,4~,/~,~ ~'.<~. ....... Size of Proposed Work: Length .... ~.~../~.~..~....%¥idtih. ~.~¢..~-....H' eighth Above High W'' ater.. ~.. '.Z~.~. .... Depth Below Low Water.~, .~.,~....~.~.~Average Rise In Tide..~..~.~. ..... Yards to Be E×eavated..f~.*~, ¢. .... Width of Canal, Creek or Bay Fronting ~ropert, y .... ~.~.~.d..'..~. ....... Depth at Low Tide . .~..~., ............ Zs 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. COUNTY O~ ) .. bemg duly sworn deposes and says that he is the applicant for the above de- scr~mit, a~d~ that d. ll statements contained herein are true to the best of his knowledge and belfef; 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 orby virtue of said permit. Notary p ' . ........ ~Term 5~pkes iVlarch 30, i~l,