HomeMy WebLinkAboutTR-186 TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
PER IT NO ....... ....
Pursuant to the provisions of Chapter 615 of the Laws of 1893 ~,f the State of
New York and Chapter 404 of the Laws of 1952 of the State of New York and in acoardonce
with the resolution of the Board of Trustees of the Town of Southold adopted at a meeting
of said Board on .......... JTan~..2~.../,~ ..................... and in consideration of the sum of
$..1.0.~..,.., lawful money of the United States, paid bY.~E~a~--~r£~n~..a~-.E~'~.-~.,
residing at ...... ~<~t3.T~h~,lc].~..J~,.;L,. .................................................................. , New York,
the said Beard of Trustees of the Town of Southold. Suffolk Count, New York, hereby
authorizes and permits said..~..~..~..~.~ ........................ to
The said ...~,¢~Lel..L$~t~..&..Jmhn.,~,..K;Lng....., as part of the consideration
for' the issuance of this permit does hereby release the said Board of Trustees and the
Town of $outhald 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 at his own expense, defend any rand all suits which may be brought by third
parties as a result of any operation corned on pursuant toot in accordance with the terms of
this permit, and assuma full liability with respect thereto to the complete exclusion of
said Board of Trustees aha the Town of Southald.
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 authorizea.
2. That there shall be no interference with the right, of the public to pass and repass
along that, portion of the beach between Iow and high water mark.
3. That the work shall be subjet:t to the supervzsion and approval of the said Board of
Trustees ar its agents.
IN WITNESS WH~I~EQF, the said Board of Trustees of the Town of Southold has
caused its corporate seal to b~ hereunto affixed and these presents to be subscribed by
a majority, of the said Board of Trustees, the day and year above, written.
~\ ......"~ ....'. ................. (L. S.)
STATE OF NEW YORK )
SS:
COUNTY OF SUFFOLK )
ON THIS...,~ ....... day of ..................... Jtme ......................... , 19~..~.3, before me
personally appeared ~lia~ ~l~ ~z'~k ~WSO~ ~ ~y.
oil personally ~n
to me, who, being by me duly sworn, severn lly said that they each resided in the Town
of Southold~ Coum~ of Suffolk, State of New York,~ and were members of the Board of
Trustees of said Town of Southold and constituted o mojori~ of the some; that they
knew the corporote seal- of said Town of Southold; t~t the seal affixed to the forgoing
instrument was such corporate seal; that it was so affixed thereunto by order of the
B~rd o~ Trustees of said Town of Southold and that each one signed his name thereto as
~ Trustee and by like order.
No. 52-03449~, Suffolk Coun~ ~
~mm~ssien ~pJres ~arch 30, ~
~OP~ ~0. !
TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
.'.'.'.'.'.:.'.'.'.'.'.'.'.'.'.'.'.' chairman, Board of Trustees
/ PPLICATION FOR PERMIt
INSTRUCTIONS
A. This application ro 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 6n diagram which is part
>f this application.
C. The work covered by this application may not be commenced before the issnance oi a permit.
D. Lrpon approval of this application. Town Trustees will, 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 co the Board ~f Trustees of the Town of Southold. Suffolk County, Ne~v
York. for the i~suance of a permit pursuant ro the laws. Ordinances and regulations governing construction of: docks,
piers, bulkheads, jettys and dredging in, under, and over the waters of Town of Southold. The applicant agrees
ro comply with ail. 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 ~f any kind.
Home address If Other Than Location .~ J,~t.~{~. ~[. !~.~,~ ..............................
Creek, Bay or Harbor Fronting Property ...Gi~. ~. t~'~J~ .............................................
Size of Proposed Work: Length. ~00. ~gt~,-~l~W~ :~h8~lt~..Heighth Above High Water..*~,~ .........
Depth Below Low Wamr ................ Average Rise In Tide. ~ .~I~.{.~ . .Yards to Be Excavated..~.?~ ........
Width of Canal. Creek or Bay Fronting Property...~l~.~. J[~) ....... Depth ar Low Tide s~.~l~.l~..~ ........
Is This For Private or Business Use? .. ~'~ltl[t~ ....................... Area Zoning ..........................
Complete plot plan to be drawn on reverse side of this application.
STATE OF NEW YORK )
)s.s.
COUNTY OF )
- being duly sworn ueposes ana says applicant for the above de-
.. ~ .tl,.~ -.. ~ . . that,~s the
scribed permxt, and that all statements contained hereto are true to the best of his knowledge and belief; that the
work will be done in the manner se~ forth in the application and as approved by the Board of Trustees of the Town
of Southold, and the applicant agrees to hold the Towh of Southold and said trustees harmless and free from any
Sworn to before me thls..,...~ ,..day of ..........
Notary public ...................... county of
~.~miss~n ~xpir~$ ~arch