HomeMy WebLinkAboutTR-364TO\A,/N OF $OUTHOLD
BOARD OF TOWN TRUSTEES
Pursuant to the provisions of Chapter 615 of the Laws of 1893 of the State
of-New Y~erk; Chapter 404 .of the Laws of 1952 of the State of New York; the pro~
vlsi.ohs of ~ ordinance entRled "Seutho}d To~ O~din~ce Regulating the Placi~g
of Obstructions ~n and on Town Waters and Pub!~c Lands, and the Remov~ of Sand,
Gravel or ~other ~ateriaIs from Lands under Town Waters", and Ln accord~ce
d%e resolution .of the ~o~d of Trdstees of the Town of Southold adopted at a meet-
ing of sai¢. Bo~d on . .~. ~,.. ~ ...... , and ~n consid~ation of ~e sum
of $.~:~.~.., ]awf~ money of the United States, paid
residing at ... '. ~..~ .~.~, · ~~..~.~,-, New ~ork,
~0krd o~T~stees qf tke Town of Souihold, Suffolk Coun~y, New York,
au~omz~d ~d peters smd . .~. ~. ~. ~ .......
The said .~.r~.t. AD.,¢.'..~;~.~k'~.'~. ~1~.I.]~9.C..I~.., as p~ of the eonsid~ati~n
for the issuance of this permit does hereby release the said Board of Trustees and
the T~own of Southo!d from any and ~1 d~m~es claims for d~ages or suits that
may arise ~or occ~' directly or indirectly as a resutt of any operation taxied on un-
der smd pursuant ~o nhis permit, and will at his own expense, d~end any and ~11
suits which may be brought by third parties, as a result of any operation c~ied
on p~suant to or in accordance with the terms of ~is Demit, and assume full
liability with respect thereto to the complete exclusion of said ~d of Trustees
and the Town of Southo!d.
T~S PERblIT is subjecr to the following terms and conditions:
i. That there MnaI1 be no ~reasonable interference with navigation as a result of
the ~ork herein auth~ized.
2. Tha~ there shall be no interference w}th the right of the public to pass and
pass along that po~ion of the beach between low and high water mark.
3. That the work ~aH Be subject ~o [he supervision ~d approval of the said
Bo~d of Tmastees or its agents.
4. That ~ future operations of the Tow~n of Southold require the remov~ ~d/or
alteration in ~e ~ocation of the work herein authorized, or if, in the opinion
of the Board of Trustees of the Town of Southold, such work s~all cause un-
reasonable .obstruction to free navigation, the said ~ .~. ~ .~%~o~k
will be required upon due notice from the smd Bo~d of T~stees, ro remove
or alter the location .of the mork hereby au~orized without expense to the
Town of .Southold, so ms m render navigation reasonably free and unobstm%ct-
ed.
t
The authority conferred by this permit may be terminated by the Board of ~rustee?
For e failure on the pa,rt of the said.,..~.~.....~...~.~...~.~..~;;.~[.~....¢~...~.. ........................ to
comply with the terms and cenditions herein ~mposed. In the event of such termination,
this permit shall be d~med rev6ked five (5) days after the date when the B~rd ef
said Gr~ & ~ ~1~ ... t~
Tru~ees shall moil to the ...............................: ..................................... ~,. ~
address given in his appf~tion, o ce~ified copy of a resolution of the B~rd of Trust~
directing such termination.
IN WITNESS WHEREOE, the said Board of Trustees of the TOwn of Southold has
caused its :corporate seaJ 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
...... (1.. S.)
..S.)
;.)
.......................................................... (L. S.)
STATE OF NEW YORK )
SS:
COUNTY OF SUFFOLK )
ON THIS ,.~. ~-/~ day of ~ept~ 1966 before me
~ersonolly appearedAivah 5. ~l~m~, ~r~ ~s~n, Jo~n
~e~ul~y, ~o~e ~son a~d ~!as
all personally known
to me, wh% being by me duly swam, severally said that %hey each resided Jn the ToWn
of Southold, County of Suffolk, State of New York, and were membe~ of the
lrustees of said Town of South01d and constituted u ~jority of the same; that they
knew the corporate s~al 0f sc[~ ~own of Southo]d; that the seal affix~ to the foregoing
instrument w~s such corporate sea[; that J[ w~ so ~flxed }hereunto by order of the
~oard o~ Trustees of said Town of Southold and that each one signed his name thereto
a Trustee and by like order.
Notary Public
~j ~ ~ ~ ~OT~Y PU~LI~ SLate ~: r?ew
FOll~ NO. 1
TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined .............................. 19 ...... Application No ..................
Approved ..... f: .... ......................... Permit ...... ...............
Disapproved a/c ........ ! ....... .j~T..~...~.../~.~ .f....~ ...... ~ .............................................
........ I ..... ..... ehairmau, 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 locgtion of lot and buildings on premises, relation to adjoining premises, public streets,
parks, etc., and giving det~,iled description of proposed layout of project must be drawn on diagram which is part
of this application.
C. The work covered by t tis 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 premmes and avail able for inspection at all times.
E. Applicant shall notify Lhe Board of Trustees upon completion of the work covered by permit.
APPLICATION IS HE} EBY 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 arid 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 1 Town free
Name of owner of premises
Street Address of Property . ..~...~9..~. ......... ~,.~..~..
Home address If Other Than Location
Creek, Bay or
Permit Requested
· and damages of any kind.
\ x, \,,
Size of Proposed Work: ......... Width .... .~. ....... Heighth Above High Water..~..
Depth Below Low Wate~.~.. · .~. ·..~.~: ..... Average Rise In Tide~'.~...~,~..~. :.Yards to Be Excavated, i~.~...vD..~.. ....
Width of Canal, Creek or Bay Fronting~Properiy.~..~.~. ..~'.u~....~.'~ ..... Depth at Low Tide~.~....~.}?..~..~.
Is This For Private or Business Use? . ..~V~&~ ...................... Area Zoning . .'~.~..e_~.. ...........
Complete plot plan to be drawn on reverse side of this application.
STATE] OF NEW YORK )
) S.S.
COUNTY o~&~ )
...~.....J~....~...~-... being duly sworn deposes and says that he is the applicant for the above de-
scribed permit, and that ail 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 ~,nd said trustees harmless and free from any
and ail damages and claims arising under or by virtue of said permit,,'
(applicant)
Sworn to before me this. .... day of..~ ......... t9~...
~ned ~ Suffolk ~