HomeMy WebLinkAboutTR-190 TOWN OF SOUTHOLD .
BOARD OF TOWN IRUSTEES
PERA4IT 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 ........ ;..,r~...;~..~..;~..~'.t' .... , and in considerati6n of the sum of
$..~.~;,O~, lawful 'money of the United States, paid: by...~.~....~,~..~.
residing at . . J .~..~'¢. ~$~.~¢.. ~.~ [., .................... ;.,., New YoFk
the said Board of Trus~e~ ¢ the Town of Southold, Suffolk Count, New ~ork, hereby
authorizes and permits said ....... ~..~..~.,~ ................................... to
The said.,.~cl~..,&..l~,~a__'z~J/~ ............... , 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 o result of any operation carried on under and pursuant to this
permit, and will at his own expense, defend an y ~and all suits which ma,/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 riability 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 that portion of the beach between Iow and higrh water mark.
3. That the work shall be subject to the superv sion and approval of the' said Beard of
Trustees or its agents
IN WITNESS WHEREOF, the said Board of Trustees of the Town of Southold has
caused its corporate seal *~o be hereunto affixed and these presents to be subscribed by
a majority of the said Beard of Trustees, fha day and year above written.
sear ....... ~.¢~..~r......(L S.)
...: .................... ( . .)
.... .........
STATE OF NEW' YORK )
SS:
COUNTY OF SUFFOLK )
ON THIS.....3..~.... ,day of ........... .~.~.~.~/'. .................................... 1'9,.6..[., before me
personally appeared ~S ~, ~'~hl~ ~Lt~ ~ ~0~'1~
oil personally known
to me, who, being by me duly sworn, severally said that they each resided in the Town
of ~uthold, Co~ty of Suffolk, State of New York, and were members of the Board of
Trustees of said Town of Southold and constituted a majori~ of the same; that they
knew the corporate seal of said TOwn of Southold; that the ~eal affixed rathe foregoing
instrument was such corporate seal; that it was so affixed thereunto by order of the
B~rd of Trustees of said Town of Southold and that each one signed his nome thereto as
a Trustee and by like order.
..........
mo~ory ~ublic
JUDITH T. ~[~
Examined..~.~-~,~./'~..~.: ......... 19 .g..2--.... Application No ..................
Approved///'~<~//C~.. ~ C....~-~-r~,. ...... Permit No .............................
Disapproved
........ . ..~.'~~o~.,~L.. ............ chairman, Board of Trustees
APPLICATION FOR PERMIT
INSTRUCTIONS
A. This application to he completely filled in by typewriter or in ink and submitted to the Town Trustees in dup-
licate.
]3. Plot plan showing location of lol and buildings on premises, relation [o adjoining premises, public streets,
parks, etc., and giving detailed description of proposed layout of project must be drawn on diagram which is part
of this application.
C. The work covered by this application may not be commenced before the issuance of a permit.
D. LTpon approval of this application, Town 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 !8 HEREBY MADE to the Board of Trustees of the Town of Southold, Suffolk County, New
York, for the issuance of a permit pursuant rd the laws, Ordinances and reg-~Iations governing construction of: docks,
pie[s, bulkheads, jettys and dredging in, under, and over the waters of Town of Southold. The applicant agrees
to l~comply with all applicable laws, ordinances, regulations and conditions specified by said ~rustees. and to hold
the Town of Southold, and all Town officials free from liability and damages of any kind.
Name of owner~of premises .... .~..~..~..~.~, .... ?..,9.~..~/?......~.~'. fl>. ..... .~..~..&.~..~..~....~..~...~.V..;.~. ....................
Street Address of Property ..... .~..~..~.q-..../~.'..~..~. .....~.?...T~..(.T.~..Qk-. .........................................
....................
FI .....address If Other Than Location ...~/¢ A~C~:<° $7r~ ..?.¢-?..~.~.5.~..~.~...~.-/~.: ..........................
Creek, Bay or I-Iarbor Fronting Property ..... .~. ~7C?./..~..c27.~..../../~..z..~7~.. ........................................
Permit Requested To: .... ?.~J. 5?. .... .D.o..C?. ..................................................................
Size of Proposed Work: Length.. /-/3' .Width....~. .l~eighth Above High Water ..............
Depth Below Low Water ................ Average Rise In Tide... ~z .... Yards to Be Excavated, .~.q.-~..*.~. ....
Width of Canal, Creek or Bay Fronting Property..,/f0Y./nj ~,~ .Depth at Low Tide .....................
[s This For Private or Business Use? .... ./9./~. ! .//fl..~.{- .................... Area Zoning ..........................
Complete plot plan rd he drawn on reverse side of this applicatlon.
STATE OF NEW YORK )
)s.s.
COUNTY OF k'l ,t;~-~ )
.'....'.:..;.T ......... being duly sworn deposes and says that he is the applicant for the above
scribq~l/permit, and that all statements contained herein are true to the best of his knowledge and belief; that the
work wiI1 be done in the manner set forth in the application and as approved by the ]3oard of Trustees of the Town
of Southold, and the applicant agrees to hold the Town of Southold and said trustees harmless and free from any
and ail damages and claims arising under or by virtue of said permit.
(applicant)
/ - '~ - / Notary Pub!ie. State of New York
No, 410322515 Queens County
Cert~cate filed in Kirks County
,Torm Expires March 30, 1964