HomeMy WebLinkAboutTR-121 TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
PeP~V~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 of the Board of Trustees of the Town of Southold adopted at o meeting
of said Board on ........... .~,.~..[y....2..D..~.....~.?..G...O. .................... , and in consideration of the sum of
$.~..5......O..0...., lawful money of the United States, paid by....~.O.~....G..'.....~..I....'~.. ...................
residing at ................ D.e,]~.~t..,~e.,...,,~.~;h~,.~.,,..,~.~, .................. , New York,
the said Board of Trustees of the Town of Southold, Suffolk County, New York, hereby
authorizes and permits said .......... ~...~....~..s...~,,.1.. .................................................. to
~re~ge an area on t~e northeasterly corner of h~s pro~Derty
on Juckey Creek, falling of area aroun~ culvert not to be
attempted un~il culvert is repaire~, all in accoraance with
with the application submitted.
The said Ec]mon¢3 G. H~11
...................................................................... , 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 directly or indirectly as a result of any operation carried on under and pursuant to this
permit, and will at his own expense, defend any and all suits which ma,/be brought by third
p(~rties 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.
II
THIS PERMIT is subject to the following terms and conditions:
Thor there shall be no unreasonoble interference with novigotion os o result of the
work herein authorized.
That there shall be no interference with the right of the public to paSs ond repass
along thor portion of the beach between Iow and high woter mark.
That the work sholl be subject to the supervision and opprovol of the sold Beard 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 year above written.
seal 7~~~...~-.~r~z:.. ( L. S.)
.............
~C;~'~..~...(L S )
STATE OF NEW' YORK )
SS:
COUNTY OF SUFFOLK )
ON THIS.......2.~.~......day of ............ .A...~.~r.~.~.~ ............................... 19...6~., before me
personally appeared .l~:t]mons Dea~,
N~ S~ffolk. ~ Philip Weil~. of ~i~t. ~; Jo~ Me~ulty, of
La~el, ~ and Alv~ Gold~l~, of $~old,~ all personally known
to me, who, being by me duly sworn, severally said that they each resided in the Town
of buthold, Co~n~ of Suffolk, State of New York, and were m~rs of the Board of
Trustees of said Town of buthold and constituted ~ majori~ of the same; that they
knew the corporate ~al of ~id 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 s~gned his name thereto
a Trustee and by like order.
........
J~DiTH T. ~OK~
POEi~ NO. 1
TOWN OF SOUTHOLD
80ARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Ap~oved~~~ ............................ Permi~ ~o ........... Z~.~
Disapproved g c ...........................................................................................................................................................................................................................................................
........................... ~~'.~ ............... chairman, Board o£ Trustees
APPLICATION FOR PERMIT
INSTRUOTIONS
A. This application to be comple£ely fined in by typewriter c~r in ink amd submitted.So the Towa Trustees in dup.-
licate.
B. Plot plan showing locaSicn of lot and buildings on prSmlses, relation to adjoining premises, public streets,
p~rks, etc., amd giving detailed description of proposed layout of project must be drawn on tiingram wkich is part of
this application.
.C~ The work covered by this application may nos be commenced before the issuance of a permit.
D, Upon approval o£ this application, Town Trustees will issue a permit to applicant. Such permi~ shall be kel~t
on the premises and available for' inspection at all times.
E. Appncant sh~l not~fy the Bca~-d cf Trustees upon comp!erich of the work coverecl by permit.
APPLICATION IS HEREEY MADE to the Boaaxl of Trustees of the Town of So~thold, Suffolk County, New York,
for the issuance of a permit pursuant to tlie !aws, Ordinances and regulations goverrdng coustrucSion of: docks,
piers, bulkheads, jettys and dredging in; under, and over the ~raters 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 ef Seutheld, and all Town officials free from liability and damages of any kind.
Name of owner of premises ~'/~/~1
S~eet Address of Prope~y ~ /~ ],~tlff/xf ~¥~1~- ............. ~-- ~C [~/~ ~ ~./~
Home a~dre,ss If Other Than,'LOcation'"'~.....-.~.~..~/'//-~.~.~'""~c:~----'"'--'"~'""- "'~'"'~"?'7"-'~'~';~'"-'. ~7)-"~
O~,~,~yor~,er,~oa,~o~r~ .......... ~..~.~.~.~,~...-......~f.~.~.~_...~ ............... ~...~.....~ ............ ~_:' .......... ~....~ .................. ~: ....
8~e of ~ro~o,~ed Work: ~en~ __..~..~ ................ i.~th .__-~...(. .............. ~eigh~h ~bove ~gh W~er ._.: ...........................
~e~ Below ~ew W~er ......~_5 .......... ~ver~e gise In ~iae ..__~_.5 .................. Yar~ ~o ~e ~ea .~.~.~.~,
~ ~ ,er ~ o~ ~in~ ~ .......... ~2~ ...................... ~ ~o~ _.~.....~_~~~~~ ................
~omple~e plat plan ~o
STATE OF NEW YORK)
_ ~// )S.S.
COUNTY ~F~ )
............ ..~...~..iiii~_..'..~ ....... being duly sworn, deposes and says that he is the applicant for the above de-
scribed permit, aaxd that a~l stateme~Ss contained h~e~ are t~e to. ~he. be~t of his knowle~e and be~ef; that the'
w~k ~ be done ~ the maker se~ fo~ in the applicatio~ ~nd as approved by the Bo~d of ~ustees of the
of Southold, a~d the applicant a~ees ~o hold the To~ ~f Southold and said trustees harmless and free from any
(applicant)
28,
Hilltop Roa~, POrt Washing~on, N.Y.
25, ~60 Permit to ctre~lge //% Jockey Creek
$ 1$ O0