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HomeMy WebLinkAboutTR-348 TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES PER V IT NO 3 Pursuant to the provisions of Chapter 615 of the Laws of ]893 of the State of New York and Chapter 404 of the Laws of ! 952 of the State of New York and in accordance with the resolution of the Board of Trustees of the Town of Southold adopted at a meeting of said Board on ......... .~...~...e......~......~.~.6..~.. .................... and in consideration of the sum of residing at New York, the said Board of Trustees of the Town of Southold, Suffolk County, New York, hereby authorizes and permits said ................. ~..~..~,..~[~ ........................................... to tn~a11 a ~eml~o~a~y ~loa~: an~ ac~ees walk tn ~ ~eek, J The said Jo~n ~, ~otle~ os port of the consideration for the issuance of this permit does hereby release the said Board of Trustees and the Town of $outhold from any and oil damages, claims for damages or suits that may arise or occur directly or indirectly as a result of an,,' 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 toot in accordance with the terms of this permit, and assume fulJ liabilit~ 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: 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. 3. That the work shah be subject to the supervision and approval of the said Board of Trustees or its agents. 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 Board of Trustees, the day end year above written, .... (L. S.) S.) STATE OF NEW YORK ) SS: ~' COUNTY OF SUFFOLK ~C~l~y, Fr~k Dawson, an~ Douglas Robert~o~. all personally known to me, who, being by me duly sworn, severally said that [hey 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 Southotd and constituted o majority of the same; that they knew the corporate seal of said Town of Southold; that the seal affixed to the 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 signed his name thereto as a Trustee and by like order. Notary Public ~_~ FORM TOW OF SOUTHOLD BOARD OF TOWN TRUSTEES TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 1' at~o~[N~ ~ .............. Examined . Approved}~, ~,;/~. ~ [. ~. f~ ...... z/ .... 7~xF' ................ Permit'fi`z-'iN o ............................. Disapprovedr a/c .................................................... ............~~,,ff~. ~ ~...~. ?.~,...,, ........ chairman. Board of Trustees PEEMIT 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 sho~ving location of lot and buildings on premmes, relation to adjoining premises, public streets, parks, etc.. and givmg 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. Upon approvaI of this application, Town Trustees will issue a permit ro 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 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 laws, Ordinances and regulations governing construction of: docks, piers, bulkheads, jet%ys and dredging in. under, and over the waters of Town of Southold. The applicant agrees to comply with all applicable laws, ordinarmes, 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 ......... ~*Q~!~.%g,,..I%KILI,~ ....................................................... ~.. Street Address of Property ....... L~I~.I~%D,.. ~TT~.~Cg,..&,.I., ................................... Home address If Other Than Location . .S~I~..0~. -Z/&?-~9- · ~3 .~*J'~lgF~..~.~K~. l~.~a-~.~. --: .... Creek, Bay Yr Harbor Fronting Property ....... Permit Requested To: ...II~l~gl/Tu .~t~I2~AI~. ~. A.ND .~G~. W~i~ ....................................... Stze of Proposed Work: Lengt.h~.~..4~1 ....... Width. ?.. ~ ...... Heighth Above High Water .... ~t~ ...... Depth Below Low Water Ft,~ ~ Average Rise In Tide ~ Yards to Be Excavated .... ~011{g,' .... Widtk of Canal. Creek or Bay Fronting' Property.. ~ti~¥~x,..~00.~ ........ Depth at Low Tide ...... ~ ............. Is This For Private or Business Use? ...... P~l'~r/~ ................... Area Zoning .......................... Complete plot plan to be drawn on reverse side of this application. STATE OF NEW YORK ) COUNTY OF ~ ) .... .d~.~:.p.~,~_....~. .......... belng~ duly sworn deposes and says that he is the applicatlt {o~ the *.hove de~ scribed permit, and that all stammenrs contained herein are true to the best of his knowledge and be5ef; that the 'work will be done ]n the manner set forth in the application and as approved by the Board of Trusmes of the Town of Southold. and the applicant agrees to hold the Town of Southold and said trustees harmless and free from any and alt damages and claims arising under or by virtue of said permit, ~ (applicant) Sworn ~o before me this ...... ~ ..... day of .... ~ ........ .. 1~ ..... Notary public... ~,,.~o~.counry of..