HomeMy WebLinkAboutTR-497 TOWN OF SOUTROLD
BOARD OF TOWN TRUSTEES
r ,CZ,T NO ...... · '7 '
Pursuant to t/he p~ovisions .of Chapter 615 of the Laws ~ 1893 of the State
of New York; Chapter ~04 of the Laws of 1952 of the State of New York; the
visions of an ordinance entitled "Sout~o!d Town O¢din~ce ~egulaiing the PIacing
of Obstructions Ln and on ~own Waters and Public Lands, and ~e ~moval of Sand,
Gravel or ,other 5{aterials from Lands under ~o~vn Waters", and in accordance with
the resolution of the Bo~d .of Trustees of the Town of Soutbold adopted at a
ing of said Board on . ¢~B¢..~,..~.8 .......... and in comideration of the sm
of S.. ~,~., lawful ~o=ey of the United States, paid by .~O~.~
the s~d
h~eby
aufil,orized and pe=i~ said .~r~X.~. ~*~ ................. to
fill in~ ~r~ ~t~ of ~st ~, ~ ~ f~ ou~
The sa~d .~Y. ~ .~ ....... as pa~ ,of ~he consldera~ion
for ~he issuance of fi~is permit does hereby rele~e %he said Board of ~stees and
the Town of Southo]d from any and ~I dema~es claims f~ damaEes or strips that
may arise ,or occur d~ect]y or indlrec~ly as a resu~ of any operation caFried on
der and pursuan~ to ~his permil, ~d will az his own expense, defend any and a~
suits which may be brouEht by ~hir~ parties, as a result of any opera~ou carFied
on pursu~ to ,or ~n accordance with ~he te~s of ~is permit, and assume ~H
]iabfli~y wilh respect theFeto to [he comple~e exclusion of said
and the ~own of Sou~ho)d.
T~S PE~IT ~s subject ~o ~he fo)lo~n~ ~erms and ~ndilions:
1.That there shall be no unreasonable ~nierference wi~h navigation as a result of
tho work herein authorized.
2.That there sha~ be no interference wm~h ~he riEh2 of the public %o pass and
pass ~on~ ~hat potion of ~e beach between low and high water mark.
S.That ~he work shall be subject to ~he supervision and approval of ~he said
Board of T~stees or i~ a~ents.
4. ~at E future ~perafions of the Tow,n of Sou%hold require ~he ~emoval ~d/or
aheratio~ in the loca~io~ of ~he work herein authorized, or if, in %he .opinion
of the Board of T~stees of the Town of Soulhold, such work ahaH cause
reasonable ,obst~c~ion to free navi~a%ion, the said ~=~ .S~S~.tO. ~es
will be required upon due not~ce from ~e said Board of T~s~ees, to remove
or alter the location of the work heFeby author~e0 wi~hou~ expen~ to
Town of Southold, so as ~o ~ender navigation reasonably free and unobs~ct-
ed.
The authority conferred by this permit may be terminated by the Board of Trustees
for a failure on the part of the said .....~.~JL~.¥.~4~.~.~..~..O...~..~..~..~., ......................... 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 ........~.~..~,~..~.~..~..~...,.]L~,.~.~. ....................... 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
a majority of the said ~oard of Trustees, the day and year above written.
sea,
(L. S3
(L. S.)
........................................................ (L S.)
STATE OF NEW YORK )
SS:
COUNTY OF SUFFOLK )
ON THIS ....... ..1.~.t,.. ..... day of .......... .-~..~.~..~. ............................. , ~0..6..~...., before me
oersonally appeared ~Al*/~h ~ ~m~t~, Fra~ ~n, Jo~ ~,
~Nulty, ~ge Simeon ~d ~ug~s
ali personally known
to me, who, being by me duly sworn, severally said that they each resided in the Town
of Southold, County of Suffolk, State of New York, and were members of the Board of
Trustees of said Town of Southold and constituted a majoriW of the same; that ~ey
knew the corporate seal of said Town of Southold; that the seal affixed to thc foregoing
instrument was such corporate seal; that it was so affixed thereunto by order of the
Board of Trustees of said Town of Southold and that each one s~gned his name thereto cs
...... ...... L...: ...
~iled ~ Nota~ Public
/ ' ~, ~'~20 S~ff~k County
TOWN OF SOUTHOLD
BOARD OF 'tOWN TRUS 'EES
TOWN CLERK'S OmC
SOUTHOLD, N. Y.
E×amined ................................ 19 ..... Application No ...................
Approved ............................................. --' Permit No ...... '~"Y7 .............
/...
Disapproved a/c .....
..................................................... chairman, Board of Trustees
APPLICATION FOR PERMIT
IN~TRUCTION~
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 which is part of this
applica'tiom
C. The work covered by this application may nor be commenced before the issuance of a permit.
D. Upon approval of this application, Town Trustees will issue a permit ro 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 Iaws. Ordinances and regulations govermng construction of: docks,
piers, bulkheads, jettys 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 all Town officials free from liability and damages of any kind.
Name of Owner of Premises ..... D..o..rp.~.h.~..q.....~p.o..~?. ,~.o... ?.a.~..h.e?. .........................................
Street Address of Property .... 8..~.~.. Lane an~ Bayberry Roac~
Home Address If Other Than Location 675 ~onkl±n 8~. ~p~ 27~ Farmilxgclale~ 3JoX' 171.735
Creek, Bay or Harbor Fronting Property . ~.efi..~...~?.e..e.k. .......................................................
Permits Requested To: .f.~..I.:1:...~n...2. .0.'..f?..o.m...h.~..g.~. va~er mark
Size of Proposed Work Length ....2.0. ] ......... Width . .~.7. ~. ...... Heighth Above High Water ..............
Depth Below Low Water .............. Average Rise tn Tide .............. Yar4s to Be Excavated ............
Wqdth of Canal. Creek or Bay Fronting Property. .~ ..... '.. Depth -~,t Low Tide .................
Is This For Private or Business Use? ...t)~.$.v.~ .~.e. ........................... Area Zoning ....................
Complete plot plan to be' drawn on reverse side of this application.
STAT~ OF NEW yORK )
)S.S.
COUNTY OF Suffolk)
............................ being duly sworn deposes and says that he is the applicant for the above described
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 sci forth in the application and as approved by the Board of Trustees of the Town of
S0uthold, 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 permi't.
Sworn to be~ me this . .~0g~ ......... day of .... ~.~Y ................ 19.