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HomeMy WebLinkAboutTR-215 TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES PE iT 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 ........... ~T.~'~....~.{....~-,.~.~ ............and in consideration of the sum of $....~.,..~.t~., lawful money of the United States, paid by.~.~.e..[...~z'....e..~.~.~~ .......... residing at ......... ~.~....~.~.e..~....~..°.~..~.-*.....~.~.~....°~...~..r....r.~.-'.:.~,.'. ............................ New York, the said Bo. ord of Trustees of the Town of Southold, Suffolk Count,/, New York, hereby authorizes and permits said .... ..~...~c~.~.~.:;.~..~....e~..~.:~ ......................................... :. to C~eek bran~ o~ ~se Creek ~o be de~si~ed on u~lan~ of ~roper~y, all in accora~nce wi~ a~Iicaeion The said .L~i~g~j~.~..~e:Jz:J.3/,~ ..........................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 suitsthat may arise or occur directly or indirectly as a result of any operation carried on under and purSuant to this permit, and will cit 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 (~ result of the work herein authorized. 2, That there shall be ne interference with the right of the public to pass and repass along that portion of the beach between Iow c~nd high water ma~. 3. That the work shall be subiect to the supervision and approval of the said Board of Trustees or its agents. IN WITNESS WHEPzEOF, 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 yegr above written. seal ~...~.. ~ ..(L. S ) ~c~.. ~.~~~,. (L. S.) (L. S.) .......................................................... (L. S.) STATE OF NEW YORK ) SS: COUNTY OF SUFFOLK ) ON THIS...~.5...'~.... ....... day of.....]~.1~.1¢?~ ............................... , 19~...; before me personally appeared Alvah B~ ~l~s~th~ oil personally known to me, who, being by me duly sworn, 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. ...... FORM NO. 1 ' TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES TOWN CLERK'S OFFICE SOUTHOLD, .N.Y. Examined., ~,~..~../~. ........... 19~.~7... Application No ................. Approved .~.~~~ .~ ....... Permlt No .... ~. [..~, .~. ............. / Disapproved APPLICATION FOR PERMIT INSTRUCTIONS A. This application ro be completely filled in by typqwrimr or in ink and submitted m 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 mns~ be drawn on diagTam which is part o~ this application. C. The work covered by this application may not bg commenced before the issuance of a permit. D, Upon approval of this application. Town Trustees will issue a permit ro applicant. Such permi~ shall be kept on the premmes and available {o~ inspection at all times. E. Applicant ~hall notify the Board of Trustees upon completion of the work covered by permit, APPLICATION I~ HEREBY i~IADE ro the Board of Trustees of the Town of Southold. Suffolk County, New York, for the issuance ora permit pursuant ~o the laws. Ordin~,nces and regulations governing construction of: docks. piers, bulkheads, ie~rys 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. Xame of owner of premises .... ~4~I~, .~/i~l~.lk~tl~ ................................................... Street Address of Property ... ~..~l~2[~-~gt. ~d~, .~J~]ti;ll~ltli ............................................... i~ome address If Other ~han Location ..... ~ .............................................................. Creek. Bay or Piarbor Fronting Property ...~ .~t~..t~.altit}l..t~-~--1~1~ ...................... Permit Requested To: .... ~1~I~.~. 4itll{~ .~!~'. ~al!~. ~}]~',lt;~.~t~ · ?l~ ':t:atltl ......................... Size of Proposed Work: Length....~.~J~.~. ~J~[.Width .... i~-~.~l~Aieighth Above High Water .............. Depth Below Low Water. ..... .~.O...~ ....... Average Rise In Tide .... ~;~i!; ..... Yards to Be Excavated....z-[..~. ~o...1~.... Width of Canal, Creek or Bay Fronting Property..~..~ .1.0. g~ ...... Depth at Low Tide ..... ..~,..-. .......... Is This For Private or Business Use? ... ~]~I,Vi~.~ ..................... Area Zoning ..I~A~. ~$iilOl~ .... Complete plot plan ro be drawn on reverse side of this application. STATE OF NEW YORK ) )S.S. COUNTY OF ~fOJJi: ) scribh!d~grmlt, and that ali statements contained herein are true to the best of his knowledge and belief; that the work will be doue in the manner set forth in the application and as approved by the Board of Trustees of the To~vn o{ Southold, and the applicant agrees ro hold the Town of Southold and said trustees harmless 'and free [rom any and all damages and claims arising under or by virtue of said permit, // '~ (applicant) Sworn to before me this .... ,/,~,, ,.~..day of. 9 ~,~. Notary p/ubt~c ..... ,~...._u:,~2:/,~..~...county of.. ~... ~ t .~. ;~ ~,. ~/-f.~. Jumper 7:.