HomeMy WebLinkAboutTR-128 TOWN; OF SOUTHOLD
BOARD OF TOWN TRUSTEES
PERMIT NO ...... J..~..,.~. .....
Pursuant to the provisions of Chapter 615 of the Laws of 1893'0f 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 a meeting
of said Board on ..~...~.~:~..~..~.....]:.?..6...0. ......................... and in consideration of the sum of
$....~,.0.,.0.0. ................. lawful money of the United States, paid by ..~.o..~..e.~...~...[.,....~..o.~.Z_~..~
residing at How~r.~..&..Me~y..A~.e,.,.,]~,t~J.t~ck,...T.,.T, ..................... , New York,
the said Board of Trustees of the Town of Southold, Suffolk County, New York, hereby
authorizes and permits said ....~g~r.~...~.,...~O. yl~, .................................................... to
dredge and improve shoreline kn Mattituck Inlet, all in
accordance with the application submitted.
The said ...... .~?.~..?..~...~.....~..,.....~...o..:y..1...~..~. ....................... , as part of the consideration
for the ~ssuance 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 a result of any operation carried on under and pursuant to this
permit, and will at his own expense, defend any and oil suits which may be brought by third
parties os a result of any operation carried on pursuant to or in accordance with the terms of
this permit, and assume full liability with respect thereto to the complete exclusion of
said Board of Trustees and the Town of'Southold.
THIS PERMIT is subject to the fat[ejwiD~ 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 low and high water mark.
3. That the work shal~ 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 and year above written.
seal ~.'.....(L. ......... S.)
...k~...../.C<~ ............... (L. S.)
STATE OF ~ YORK )
SS:
COUM~ OF SUFFOkK
O~ THIS....~..d~y o{ ......... ~ ................................. , 19....~..., be{oro me
of ~ Suffolk, ~; ~ult~, of ~el, ~; ~ili~ Weil~.
of ~i~t, ~ a~ ~v~ ~ld~h, of So~t~li~onaily known
to me, who, being by me duly sworn, severally sai~ that they each resided in the Town
of Southold, County of Suffolk, State of New Yark, and were members of the Board of
Trustees of said Town of Southo[d and constituted a majority of the same; that they
knew the co~orate seal of said Town of Southo]d; that the seal affixed to the foregoing
inst~ment was such corporate seal; that it was so affixed thereunto by order of the
Board of Trustees of said ~own of Southold and that each one signed his name thereto as
~ Trustee and by like order.
~ ~ublic. S~te ~[ New
~ 52~344963, Suff~ C0u~
TOWN OF SOUTHOLD ~, ~_~.~. ~..,
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD,' N. Y.
~xammea ......~.....~..!: ..................... 19..~ ........ Applicatio~ No .............................................
~ppro~e~ .... ~ ................................... Por~ ~o ....... ~ ...........................................................
DSsappreved ~/~ ..........................................................................................................................................................................................................................................................
~~.~ ch~n, Bo~d of ~ustees
APPLICATION FOR PERMIT
~ST~OT~0NS
A This app~cation'to be comple%ely ~ed ~ by type~iter o~ ~ mk ~d sub~tted to the Tow~ Tr~tees ~ dup-
~c~te.
B. ~1o~ plan showing locatic~ o,f lot a~d b~l~ngs on premises, re~tio~ to adjo~ng pre~ses, pubic s~eet~,
p~ks, etc., and giving detailed desc~ption of p~opo~ed l~out ef project must be dra~ en ~g~m wMch is p~e~[~
this' application.
C. - The work cove~d by this app~cation may not be commenced before the issu~c~ of a permit.
D. Upon approval of this a~plicaticn, Town Trustee~ w~ issue s petit to appoint. Such permi~ ~ be ke~t
on the p~emises and available-for ~spection at ~ t~mes.
E. Applicant shah notify the Bo~d o,f ~stees upo~ completio~ of the work cov~ed by permit.
~PLICATION IS HERE~U M~E to the Board of ~stees of the Town of So~thold, Suffo~ Oo.~ty, New York,
for the issuance of a petit pursuit to the laws. Or~nces and reg~ations governing construction of: docks,
piers, bul~eads, jettys and ~ed~ng ~; under, and over the ~ters of Town of So~h~ld. The app~cant agrees
to comply ~th ~ app~c~ble laws, er~ance~, reg~atio~s a~ con~tions specified by s~d t~stees, and ~o hol~
t~e Town ~f Southe~d. and ~ To~ o~ci~s free from liab~y and d~mages of ~y ~d.
N~e of o~er of ~rem~se, ......... ~._~ ......... L......~........~.~ ................................................. ~ .......................................................
S r,e ..................
~o,e ~ess ~ om,r ~ L,c~,o~ ........ ~..~.~.,~..~..~....~.,_..~~_~.~...~.,~.,_~.~ .......
Creek, Bay er Harbor Fronting ~roperty ......_~.~...~m..~...~.,~-.-.~L.~.~-..~ ................................................
S~e ~f ~rop~se~ Work: Leah .....Z..~.~..:. ........... Wigth ...~.,.~ .................... He~ghth ~bove, HigkWater ...............................
................ ........ ......... ......
~ ~ j ~
Width of ~an~, ~reek ~r ~ay Fro~in~ ~pe~y ....... [~,....~ ................ : ....... De~th ~t Low ~de ......... ~ ...................................
~omplete plo$ ~lan to be d~a~ on ~eve~se ~ide of tMs application.
STATE OF NEW YORK)
00UNTY 0F ...~..~)
.................... .~...;._..~;~_~mng duly swo,. deposes a~d saFs that he is the a~pB,a,$ for the above de-
sc~bed per,t, a~ that ~ ~a~,e~ents contained he~e~ are t~e to the bes~ of his k~owle,dge a~d be~ef; ~h~t the
work ~ be done in the m~ner set forth in the application ~d as ap~oved by the Bo~d of ~stees of the
of Southold, ~d ~e app~cant ~ees ~o hold the To~ ~f Southold and said trustees ha~less ~ free from any
and ~ damages and claims a~sing under or by virtue of s~d peril/.. ~ ~, ....... -~ . ~~
,: (applicant)
Sworn to ~efgre. me/this .........~..: ........... day o~ ...~... 19.~.. f
No~ary/~I~.~ oounty of~._~~
~ot~/ Fub',c State cf F:~w Yo~k ~/~/
~o 52-0344963, Suffolk