HomeMy WebLinkAboutTR-605 TO\NN OF SOUTHOLD
BOARD OF TO%'N TRUSTEES
...... ....
z_ t"
Pursuant to the p~ovisinns ,of Chap to_ 615 of the Laws of 1893 of the State
of New ~ozk; Chaplet 404 of the Laws of ~952 of the Sta~e of NeW York; the p~o-
visions of an ,ordinance entitled "Southnld Town O~din~ce Regulating ~e Placing
of Obs~ct~ons in and on T,own RVaters and ~blic La~ds, mhd the Remov~ of
~ravel or other ~¢aleriats from Lands under ~own Waters", ~d Lq acc~dance with
the resolution .of the Bo~d .~f Tr~]stees of the Town of Soutt~o~d adOpted at a meet-
~ng of said Board on ..... ~y..4,. i~7~ ........ and in consideration of the sum
of $.lD.~00..., lawful m.oney of the United States, paid by .... ~f~.~Y .......
residing at ...~a~. ~i'~e..~e~,. ~o~hol~, ......... , New York, ~e said
Board of Trastee~ of the Town 0f Southold, Su~olk County, ~ew York, hereby
authorized and per, its said ............. Dia .~y .........................
b~ild a floating d~k a~ ramp 12'x 6' x 10' ~ ~t
off ~ar Dri~ in front ~f his o~ pro~rty, all in
The sai~ ......... ~$~..~ .................. as 9~ .of ~he consideration
for the ~ssuance of th~s pe~it does hereby release the .sa~d Board of ~s~ees and
~n~ Town of Sou~hold from any and ~1 ~ema~es cla~ms fo~ d~a~es o~ su~ts
may a~se ~or occur dlrec~ly er indh~ectIy 5s a re.sul~ of any operation taxied on
a~ n~s o~n expense, defend any ~d eH
~er and pursuan% %o ~his pe~t~ and will + ~'
su~ts which may be DrOUght by third 9ar%~es, as a ~esu-~ ef any operation ca~ed
on pursuan~ ~o .o~ in accordance ~h ~he te~ms of ~is pe~it, and assume full
liability w~th respect thereto ~o the complete exclusion of said ~d of T~s~ees
and ~he Town of S.outhold.
THIS PER~IT is subject ~o ~he fo]Io~in~ ~erms and candit~ons:
i. ~s~ ~here shall be no unreasonable ~n%eEerence with navigation as a result of
%he ~ork herein authorized.
9. Ths~ there sha~ be no ~n~erference w~th the r]Eht of the public to pass and
pass alon~ ~hat po~on of ~he beach between lo~ and high water mark.
S. Th~ the work sh~l be subjett %o %he supe~is~on ~d appDoval of ~he
Board of Trustees or i~s a~e~s.
~. That ~f future operations of ~e To~.n of Southold re~u~e ~he remov~ ~d/~o~
ahera~ion ~n %he location of the ~ork here~n authorized, or ~f, ~n ~he
of the Board of T~s~ees of ~e Town of South.old, such ~ork ~all cause
~11 be required upon due 5or,ce from the said Board of T~s~ees, to remove
or alter ~he location .of ~he ~ork hereby author~ed wi%hour expense ~o the
Town of Southold, so as ~o render nav~Eat~on reaeonsbly free and unobst~c~-
ed.
The authority conferred by this permit may be terminated by the Board of Trustees
for a failure on the part of the said ....... .~...a...~. .............................................................. 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 ............... ~.~.~.,~,~. .................................................... at the
address given in his application, o 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
o majority of the said Board of Trustees, the day an~/eor above written.
seal .... ~ ......... L,...~_(L. S.)
STATE OF NEW YORK )
SS:
COUNTY OF SUFFOLK )
ON THIS .....8Y-~3 ....... ; day of ............... JU3/B ........................... , 19...2.Q, before me
oersonally appeared AtVah B, ~old~mith, Frank Da~on~ George
Si~on, J~n F. Mc~ulty and Dougla~ ~bertson,
all personally known
~o me, who, being by me duly sworn, severally said that they each resided in the Town
of Southold, County o~ Suffolk, State of New York, and were members of the Board of
Trustees of said Town of Southold and constituted o mojori~ of the same; that they
knew the cor~rate seol of said Town of Southold; that the seal affixed to thc foregoing
~nstrument was such corporate seal; that it was so affixed thereunto by order of the
~oard of Trustees of said Town of Southold and that each one signed his nome thereto as
~il~ No~a~ Public ~
~?XRY ~U~qC, 3t~te cf ~ew y ~
TOWN OF $OUTHOLD
BOARD OF TOWN TRUSTEES
TOWN CLERK'5 OFFICE
SOUTHOLD, N. Y.
^pproved "(¢"/''¢' ................... Permit No ......................
/
........ chairmam Board of Trustees
APPLICATION FOR PERMIT
A. This application to be completely filled in by typewrFrer or in ink and submitted to the Town Trustees in dup-
licate.
B. Plot plan showing location of lot and buildings on premises, rela'tion to adjoining premises, public streets, parks,
etc., and giving detailed description of proposed layout of project must be drawn on diagram whfch is part of this
applied'don.
C. The work covered by this application may not be commenced before the issuance of a permit.
D. Upon approval of this application, Town Trustees will issue a permit to applicant. Such permit shall be kept on
the premises and available for inspection at all times.
E. Applicant shall notify the Board of Trustees upon completion of the work covered by permit
APPLICATION IS HEREBY MADE to the Board of Trustees of the To~vn of Southold, Su{{olk County, New
York, for the issuance of a permit pursuant to the laws, Ordinances and regulations governing construction of: docks,
piers, bulkheads, jettys and dredging in, under, and over the waters of Town of Southold. The applicant agrees
to comply ~vith all applicable laws. ordinances, regulations and conditions specified by said trustees, and to hold the
Town of Southold. and all Town officials free from liability and damages of any kind.
Name of Owner of Premises ........ D.!~ .~.5[ .................................................................
Street Address of Property .. IgBI~R, DRIT~J~.¥~S~.~. SOUTHOLD~, lng;%/..~ORK .11971. .........................
Home Address If Other Than Location . .~.7..~...S?.R..~g..~., .~..~.; ~.O..~:. j..~.. 7.O..R~.. .......................
Creek. Bay or Harbor Fronting Property ....~g..S.T...L..J~.$ ......................................................
Permits Requested To: .... BIIlLD..FI~OAI2r, NG..~ .~ID. l~ItlR ..............................................
Size of Proposed Work: Length . J,l~.~.+. .~.*. ..... Width .10.*. 2 ...... Heighth Above High Water ...ltl.'! .......
Depth Below Low Water .............. Average Rise In Tide . .BO.." ......... Yards to Be Excavated ...........
Width of Canal, Creek or Bay Fronting Property ....................... Dept~ a~ Low Tide ..................
Is This For Private or Business Use? ..... P~..~.'V~.~.~ ......................... Area Zoning .... IRF:~ ............
Complete plat plan to be drawn on reverse side of this application.
NEW YO X )
)s.s.
COUNTY OF ~lJl~O~ )
permit, and that all statements contained herein are true to the best of his knowledge and belief; that the work
will be done in the manner set forth in the application and as approved by the Board of Trustees of the Town of
Southold. and the applicant agrees to hold the Town of $outhold and said trustees harmless and free from any and
ali damages and claims arising under or by virtue of said permit.
(applicanl~)~
Sworn to before me .........
Notary public ......... (_~:.,~...~.. .................. County of .~ .............
Qualified in Suffolk Count",,q ~ /
term ~Ri£es MarcL~3~0~ _ .