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HomeMy WebLinkAboutTR-323 TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES PEP, 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 ofr 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......~;T.~_j, ~...I.~ .......................... , and in consideration of the sum of $.2~'~GG.., lawful money of the 'United States, paid by ...... ~ala~E,.2).~..lili,ti[~r~,~ ............. residing at ..[~....e.P...~I.~..l_,~...~,..i,,v..e..~.., .[~...t...~..i..~..~..c~_.~,.,_~.~.~ ........................... , New York, an~ 1669 East 9th St., Brooklyn, ~.y. 11223 the said Board of Trustees of the Town of Southold, Suffolk County, New York, hereby authorizes and permits said ...............t,T,,~S l~..~i,gi~li~. .......................................... to bulld~a 3' retat~ing bul~a~ in front of his ~r~erty on Dee~ Hole Creek~ a~l 1~ &ecor~an=e wtt~ ~e ap~liea~lo~ smbm~te~. ~uik/~ea~ ~ $25.0~, Fill $2.~ - ~tal $27.00. The said .....~.~..~..,,~..,.....~..~..?.~...s. ............................... as part of the consideration for the issuance of this permit does hereby release the said Board o~ Trustees and the Town of Southold fram 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 a~ y ~and all suits which may be brought by third parties as o result of any operation carried on pursuant to ar 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 Beard of Trustees of the Town of Southotd 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. year above written. seal ........ S.) ............................................................ (L. S.) STATE OF NEW YORK )SS COUNTY OF SUFFOLK ) ON THIS ....... ~.~........day of ....... ~ ................................ 19..,~..~.~, before me personally appeared ~lV~ B. ~~, ~ ~, ~ ~ ~ge ~so~ a~ John F. ~1~, 011 personally known to me, who, being by me duly sworn, severally said that they each resided in the To~ of ~uthold, C~n~ of Suffolk, State of New York, and were members of the Board of Trustees of said Town of Southold and constituted a majori~ of the same; that they knew the cat,rate se~ 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 ef Trustees of said Town of Southold a nd that ~ch one signed his nome thereto as a Trustee and by like order. ~ ~ot~ Public ...... ~ .............  ~' /~ ~ F~AR,ON A. REGENT ~erm ~p~res ~arcb 30~ [9~7 TOWN OF SOIJTHO/D BOARD OF 'TOWN TRUSTEES TOWN-CLERK'S OFFICE SOUTHOLD, N. Y. E×amined ............................. t9 ...... _ Application No .................. Approved ... ............. ... Permit No .... .................. ...... ............ .. .... . ................~~~~ ..... c~]~m ~o~d of ~stees 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 ro adjoining~ premises, public s~eets, parks, em.. and giving detailed description of proposed layout of project must be drawn on diagram which is parr of this application. C. The work covered by this application may not be commenced before the issuance of a permit. D. U~on approval of this application. Town Trustees will issue a pemit to applicant, Such permit shall be kept on ~he premises and available {or inspection ar 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 pemit pursuant to the laws, Ordinances and regulations governing cohs~uction of: docks, piers, bulkheads, jettys and dred~ng in, under. ~d 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 ali Town officials free from liability and damages of any kind. ~ o~ ow~ of p~s~s ...... .4~.~-~... P,..P!M~N~ ................................................. Stree~ Address of Prope~ ....... ~...~ ff... ~}~... -~%~ T~ ~ ~... ~ ~,. ................. Home address r{ Other Than Location . ].6.~.~..~... ~.0... ~.. ~.~.~ ~[... ~J~,.. ~.%~-~ ........ Creek. Bay or Harbor Fronting Property .... P.g.ff~...~.~.~....¢.~.~ ................................... Permit Requested To: .. ~ ~. ~ ~ .~.. ~.. ~ ~.. B .~ J~. ~;~ ~....~.~ .h ~. ~ ~ ~ ............................. Size of Proposed Work: Length..~.~Q ........... Wldth..~ ......... ~elghth Above ~igh Water.../....~_~. Depth Be]o~ Low ~ater...~ ....... Average Rise In Tide..~. .......... Yards to Be ~d.. Width of Canal, Creek or Bsy Fronting Property Q~. ~[ ....... Depth at Low Tide ... 2 f ...... ; ........ ~ Tnb Fo~ ~ri~te o~ ~u~i~es~ U~ . fg~YaT~ ..................... A~ Zonm~ ...~.~(~%~iA$.~. .... Comp]e~e plot plan zo be dr~n on reverse side of this application. STATE OF NEW YORK ) )S.S. COUNTY OF ) ............................... 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 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 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. ~ ~--_ [! (applicatOr) Sworn to before m/2-is... ~ ...... da) of.~-~..]cfl9f..F~.... (J '