HomeMy WebLinkAboutTR-442TOWN OF $OUTHOLD
BOARD OF TOWN TRUSTEES
Pursuant to the provisions ,of C~napter 615 of the Laws of '1893 of the State
of New York; Chapter 40zl of the Laws of 1952 of the State of N~w York; tl~e p~o~
visi.ons of an ordinance entitled "South.old Town Ordinance'Regulatingthe Placing
of Obstructions m and on Town Waters and Public Lands, ma_d the Removal Of Sauc~,
Gr,/ce! 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 a meet-
ing of said' Board on . .~,..~..U.~..~,...~.5.,...~.9.8..8 ..... and in consideration Of the sum
of $.... ~*~., lawful money af the :Unite:d States, .paid by .'P~
resid~n~, at 5~06 ~.3~ ~.,..~.~.i,~..,..a.~. ........ , New ~mik, ~he Sa/d
~o&rd 02 ~ ~ Y, , Y
autko~:ized a~d permi~ts said ........ JP~e .~ro~ ....................... to
~are~ alemg inhere lime 30' ~ J,~' (~ ~r~s)
The said .... .~¢..B..e...L~..~.r.e..n ................... 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 d~mages claims for damages or suits that
may arise ,or occur directly or indirectly as a result of any operation carried on un-
der and pursuant to this permit, 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/t~own 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 we~k herein authorized.
2. That thm-e.s, hall be no interference with ~e right of the public to pass and re-
pass along that portion of the beach bet~veen low and high water mark.
3. That the work shall be subject ~o the supervimon .and approval of the said
Board of Trustees ,or its agents.
4. That if future operations of the Tow.n of Southold require the removal and/or
alteration in the 1,ocation of the work herein authorized, or fi, in the ,opinion
of the Board of TFdstees of the Town of Southold, such work .shall cause un-
reasonable obstruction to free navigation, the said ...R. ql¢..e..1¢¢.~.r..e~ .........
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 ~,o render navigation reasonably free and unobstruct-
ed.
The authority conferred by this permit may be terminated by the Board of Trustees
for o failure on the part of the said ............ ~..~.....~?,.~,?..?..~.j ............................................. to
comply with the terms and conditions herein imposed. In the event of such termination,
this permit shall be deemed revoked five (5) days after the date when the Board of
Trustees shall mail to the said ....................... ..~,...~..~.:..~.~..~.,.~,.~,. ................ ; ................. 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 Board of Trustees of the TOwn of Southold has
caused its corporate seal to be hereunto affixed and these presents to be subscribed by
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 ....~.~,~. ......... d~y of ........... .~.~..~...~.~_..r~ ..................... , 19~.~.8.., before me
personaJly appeared AI~ ~. ~Id~i~. ~k ~on~ John F.
all per~ally known
to me, who, being by me duly sworn, severally said fha¢ they' each resided in the Town
of Sauthold, County of Suffolk, State of New York, and were membe~ of the Board of
· rustees of said Town of Southold and constituted a majority of ~he same; that they
knew the corporate seal of said ~own of Southo]d; ~hat the seal affixed ~o the foregoing
instrument was such corporate s~l; that it was so affixed thereunto by order of ~he
Board of Trustees of said ~own of Southold and that each one signed his name thereto as
a Trustee and by like order.
TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ..... (~' i,' ..................... 19 ..... Application No ...................
Approved ..... ~.?,r-flP:~....'..~.~..~.J.l..~.~.~.~. ............. - ~ermit No .... ,~..¢...~.. ........
Disapproves a/c 'iiiiiii i ii i i i i i .......
APPUCATION FOR PERMIT
INSTRUCTIONS
A. This application to be comple.tely filled in by typewrker 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 descr/ption of proposed layout of project must be drawn on diagram which is parr of this
application.
C. The work covered by this application znay not be commenced before the issuance of a permit.
D. Upon approval of this application, To~vn Trustees will issue a permit to applicant. Such permit shall be kept on
the premises and available for inspection ar all times.
E. Applicant shall notify the Board of Trustees upon completion of the work covered by permit.
APPLICATION I8 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, iettys and dredgSng m, under, and over the wa*ers 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 ail Town officials free from 1/ability and damages of any kind.
~ame of Owner of Premises .... ~.< ./~.. ~.~.. ~'.'.~.~ ......................................................
Street Address of Property .... [ .~.oZ"..~..~....5~...~Z~...~.?..~., ....................... , ...............................
Home Address If Other Than Location ...~'.~.~.. .... ~_~/.~....~./ . ~,.ff.~.~.~../.o(..~....~,~....,..~..~... ...........
Creek, Bay or Harbor Fronting Property ..... .~../~..'/~....~/./'.~.~I~. ................................................
Permits ~e~nested To:..~..r~./~..~/~.?....~.~.~...~-~.. ................................................
Size of Proposed Work: Length .... ~.~f...' .... Width ..../..~, .~ .... Heighth Above High Water ./..~, .~.~,./. ....
~' .Rz~' ........
Depth Below Low -VVater .............. Average Rise [n Tide ....~ .... Yards to Be Excavated ...~.:~.
Width of Canal, Creek or Bay Fronting Property ...... ~.~.~. f ............. Depth at Low Tide .~..ff~ ...........
ls This For Private or Business Use?.. ,/_~,~L'~r,~...~ .......................... Area Zoning _ .~,~/.~.~.,f~x~'~'...
Complete plo~c plan to be drawn on reverse side of this application.
STATE OF NEW YORK )
)s.s.
COUNTY OF )
... ~.~.*.~. ~. ~. .....
............. ¢.o.rl~..[,o..C. rg.n.., being duly sworn deposes and says that he is the applicant for the above described
perm/t, 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
Southold. and the applidant agrees to hold the Town of Southold and said zrustees harmless and free from auy and
all damages and claims arising under or by virtue of said permit. ........
........
(applicant)
Sworn to before me tbis,..5.t.h. .......... day of . .~.0.N..U..~ ............ 19..6.8...
~o. 41.040~00 - Q~ ~tm~ .