HomeMy WebLinkAboutTR-255 TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
......
Pursuant to the provisions of Chapter 615 of the Laws of 1893 of the State of
New Yorkand Chapter 404 of the Laws of 1952 of the State of New York and in occorda'nce
with the reselutian of the Board of Trustees of the Town of Southold adopted at a meeting
of said Board an......N~..,~,...~,~F:~ ....................... and in consideration of the sum of
$.[~,,.~.,., lawful money of the United States, paid by...,,.~.,,~.,~.~..~. ....
residing at ...... ~.$~...~.~..~.~....~R~.~.,.~.~,....~ ................. New York,
the said Board of Trustees of the Town of Southold, Suffolk County,, New York, hereby
authorizes and permits said...~.~$~...~..~.~..~.$~ ..................................... to
~ro~y on ~tt ~ Southol~. N~.. ~al l~ng~
~i~ 48~ (16' ~uk-16~ R~- 16~Fl~t), all in
The seid ..~...~.~.~.~....&....~...N:...~...t~....~.,~,. ............... , 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 suitsthat may ariseor
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 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 fall liability with respect thereto to the complete exclusion of
said Board of Trustees and the Town of Southold.
THIS PERMIT i~ subject to the following terms and conditions~
I. 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 high water mark.
~¢f~*~ 3. That the work shall be sUbject to the supervision and approval of t~e ~ d Board of
Trustees or its agents.
IN WITNESS WHEREOFi the said Board of Trustees of the Town of Southold has
caused its ¢orp0rate 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 ..... , ,
~- c, .,,. ~ ................... L....~ ............. )
............................................................ (L. S.)
· ,,? ~,, . ........................................................... (L. S.)
STATE OF NEW YORK )
SS:
COUNTY OF SUFFOLK )
ON THIS.....2..?.~ ...... day of ............. ~:r~l ............................... , 19,.66.., before me
personally appeared Frank Dawso~ John Mc~ult~ ~h£1ip ~eile~
alt personally ~own
to me, ~0~ being by me duly sworn, severally said that they ~ch resided in the Town
of Southold, County of Suffolk, State of New York, and were members of the Board of
Trustees of soid Town of Southold and constituted ~ majority of the ~me; t~t they
knew the corporate seal of ~Jd Town of Southold; that the seal affixed to the foregoing
instrument was such cor~ra~ seal; that it was so affixed thereto by order of the
Board of Trustees of s~id Town of Southold and that ~ch one signed his nome thereto os
a Trustee and by like order.
p bli ............... ..........................
[er~ E~pires ~arch 80~
TOWN OF SOUTHOLD ~ i ~/~f/,
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD. N. Y.
Examined ...~,.. ~...~ .......... 19...~,~,. ..... ' Application No ...........................
Disapprov*~ ...............~[[ [[ ~~; X.'~.['.['.'.' j 'j;;; :::::::::::::::::::::::::::: ................................
A. This application to be completely filled in by typewriter or in ink and submitted to the Town T~stees ia duplicate.
Plot plan showing location of Eot and buildings on premises, re]~fio~ to Qd~oinin9 premises, public streets, porks, eic.,
and giving detailed JescrJption of proposed layout of project must be drawn on, diagram which is pa~ of lh[s appli-
cation.
C The work covered by th[:s app]icai[on may not be commenced ~efore the Jss~nce of a permit.
D. U~n~ approv~[ of this ~pplJcatJon, Town Trustees wJlJ issue a permit to applicant Such permit shall be kept on the
~remises amd available for inspection at a'[I times.
[. Applicant shall ~otJ~ ihe Boa~d of Trustees upon completion of the work covered by perm4t.
APPLICATION ~S HEREBY MADE to the ~oard of Trust,s of the Town of SouthoM, Suffolk Count, New York., for the
~ssuance of ~ ~ermit pursuant to the Jaws, ordinances and regulations governing consiruction of: docks, pie~s, bulkheads,
fait) s and dredging in; under, and over the waters of Town of Southold. The appJJcflnt agrees to compel with all
cable bws, ordinances, reguJalions and cond tions specified by s~Jd trustees, end to hoed the Town o~ So,tho]d. and
Town off]c[aJs free from ~iabi][ty~ ~~ana damages of any kind. ~
........................................................
of ......... ...................................
Home Address ~f Other Than Locaffon ....... ~ ...................................................................................................................
Creek, Bay or ~orbor F~t,ng Pr°P~~'>~'[~i"~~z~ ~Z
Permit Requested To: ~..~.~..~ ......... ~. ....... ~.~.~.~. .....
Size of Proposed Work: Length .~..~/..(.~..~.,. Width ~[....~..~......~. Height~bove High
Dep[h ~eJow Low Water ~..~....~. ......... e Rise ~ Tide ~ ...................... Yards To Be Excava~d ~.m .......
Width of Canal, Creek or Bay Fronting Pr~er~ ................................ Depth at Low Zid~ .~..,...~.~[ ...............
Js This For Private or Business Use? ..~~ ............................... Area Zoning ~~ ......................
Complete F Jot ~lan to be arawn o~ reverse side of this application.
STATE OF ~EW.,YORK)
)S.S.
.~...~..._..~....;~-~.....,/..~,i,,~.~baing duly sworn, deposes and sog, s that he is the applicant for the above described
permit, and that ~[ sror~-' -" -'-,'ements contained herein ore true to the best of h s know~edge and be eu that the work wiU be done
in the manner set forth ~n the app[ic,a¢ion and os approved by the Board of Trustees of the, Town of SouthoM, and the
applicant agrees to hoed the Town of SouthoJd end said trustees harmless and free from any and ail damages and claims
or,stag under or by ,4rtue of said permit.
(*pplicant)
Sworn to be.o~ me this ._~.~..... day of
~ ~2'~2a~t25 Su[fdk
~.er~ ~xp~res ~ar~h 30