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HomeMy WebLinkAboutTR-154 TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES PERMIT NO.....3:.5...~. ...................... 2 ~_~ Pursuant to the provisions of Chapter 615 of the Laws of 1893 of the State of New York; Chapter 404 of the Laws of 1952 of the State of New York; the provisions of an ordinance entitled "Southald Town Ordinance Regulating the Placing of Obstruc- tions in and on Town Waters and Public Lands, and the Removal of Sand, GraveJ or other Materials from Lands under Town Waters", and in accordance with the resolution of the Board of Trustees of the Town of Southold adopted at o meeting of said Board on ......... .~....~...,.~......~...8.~....~. ....................... and in consideration of the sum, of $ ........~...,..O..O., lawful money of the United States, paid by..,,~[:~...~.~...k~.~...~..~"~.~ ............. residing at ............ ~g.~...~...~.~..~.,~.~.~,..~...~.'.~.-~..~.,.:~., ..................... New York, the said Board of Trustees of the Town of Southold, Suffolk County, New York, hereby authorized and permits said ................. .~.:..,.~..~....~..~.~.S....~J...~..~...~. ................................................... to lo~e ~t~ (2) ~les 12' from bul~ea~ for boa~ The said ........ ....?.?....~..:.....~..]t..e.~.~.~.~.~~. ...................... 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 per- mit, 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 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 thrat 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. That if future operations of the Town of Southold require the removal and/or altera- tion in the location of the work herein authorized, or if, in the opinion of the Board of Trustees of the Town of Southold, such work shall cause unreasonable obstruction to free navigation, the said ..... ?..".....~..-.....F..~..G..,~_.~.~..~..~...~. ................. will be required upon due notice from the said Board of Trustees. to remove or alter the location of the work hereby authorized without expense to the Town of Southold, so as to render navigation reasonably free and unobstructed. The authority conferred by this perm it may be terminated by the Board of Trustees for a failure on the part of the said ................ .~..~...~,,...~.~...~.~.~.'~.~. ................................ to comply with the terms and conditions herein imposed. In the event of such termination, this permit shall be deeme, d revoked five (5] days after the dote when the Board of Trustees shall mail to the said ............ ~.~...jR,,..~[.e,~{~,;i~ ...................................... at the address given in his application, a certified copy of a resolution of the Board of Trustees directing such termination. IN WITNESS WHEREOF, the said Bcard 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 .... ) ........ ....... STATE OF NEW YORK ~ SS: COUNTY OF SUFFOLK ) ON THIS ..... .~.,~.~..,..day of ....... ~..~.t~.~ ............................. 19...~.],., before me personally ap~ared ~ ~, O~ ~ personolly Known to me, who, being by me duly sworn, severully soid t~ot they etch resided in t~e Town of Southold, Coun~ of Suffolk, Stute of New York, und were members of the Bocrd Trustees of said Town of ~uthold ond constituted o mojority of the same; that they knew the corporcte se~l of soid Town of Southold; that the seo] off,xed to the ~oregoing instrumenf wos such corporote seol; thor it wos so offixed thereunto by order o~ the Boord of Trustees of sold Town of Southold end thot etch one signed his nome tl~ereto a Trustee and by like order. /~. ~ ~~~,~ .............. JUDITH T. ~0t2F~ Pubiic. State of New No. 52-0344963 Suffolk Coun~ ~omm{ssion Expires M~zch 20, FORM NO. ~ TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES TOWN CLERK'S OFFICE SOUTHOLD, N.Y. ~~~' '~ 3~ - ....... .................. .... ...... ...... Disapproved a,~c~c-'b/~-~;J.;.~ ...... ~ ........................................................... ,' ........ ...~_~~...,dtQ~'~:~.,.~-:~ ........ chairman, Board of Trustees //APPUCAT~ON 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 ~vhich 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 w/Il 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, New York, for the issuance of a permit pursuant to the laws, Ordinances and regulations governing construction Of: docks, piers, bulkheads, 3ettys 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 a 1 Town off~cmls free from ~haMhty and dama~res of any kind. ~ame of o,¥ner of premises . . .'~. .~. . . . .FT. /.e,~. C,~ ~.'ff:. ?. .~. .-. ......... ~. .... :.. '.. ............... ~. . ........... ..... ,., . y. . ........ ...... ,./..:/:. ........ ,... Home address If Other Than Location ' , ~ ...... Creek, Bay or Harbor Frorglng Pwperty .... /~.~<.zZ/e.$ ......~.~.e.e:/kT.:...,', ........', .... - .... --.,..,...-~-..~ Permit Requested To: .../k0.(~.~.{' .... ,~.-..~© Size of Proposed Work: Length..~ ........ /.. ..... Width ...... //.. .... ~elghth Above High/vVater .... Z~../. .~../.. Depth Below Low Water ............... Average Rise In Tide ..... ~-;r.F. .... Yards to Be Excavated ........... :.. Width of Canal, Creek or Bay Fronting Proper~.g~.', ....... ,/.Depth at Low Tide .................. Is This For Private or Business Use ........ ~. ~. L~d..~/-.~ ............. Area Zoning .......................... Complete plot plan to be drawn on reverse side of this application. STATE OF N~V)/ YORK ) COUNTY 0 scribed permit, and that all/-~fatements 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 and said trustees harmles~ and free from any and all damages and claims arising under o.r by virtue of said permit. Sworn to before me .. d..~,.~.,,.day .. 19 ....... Notary public..