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HomeMy WebLinkAboutTR-240 TOWN OF $OUTHOLD BOARD OF TOWN TRUSTEES P£P,~IT NO ............,. ........ Pursaan~ to the provisions of Chapter 615 of the Laws Of 1893 of 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. ........ ~T~.~.~....~...~.~.....~..,g..~..'3.. ..................... , and in consideration of the sum of residing at ....... ..~,~,~..,~.~,,k...,P,.~.~.~...~?..I.,~.~....L...~.~.? ........................... , New York, the said Board of Trustees of the Town of Southold, Suffolk County, New York, hereby authorizes and permits said.,.....J.J.a.~.b.,...~...~..~..~....~. ............................. to ~ra~a ~he area £,~ fr~a~ ~ ~he/x ~:F ~ Jo~ ~k The said ....~..~.~....i~...~..~...~.~,.~.~.~.~..., 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 oil 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 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 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 following terms and conditions: I. That there shall be no unreasonable interference with navigation as o 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 shall be sub|ect to the supervision en~ approval or,the said Boa,rd of Trustees or its agents. IN WITNESS WHEREOF, the said Bcard 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. - ': S.) : .......... STATE OF NEW YORK ) ss: COUNTY OF SUFFOLK ) ON THIS.....,9,6-~,,~.....da¥ of .............. ~.~Jr~ ............................. 196.3..,, before me personally appeared ~_s ~, i~'a~.t~ ~ ~.'~ ~11 p~rsonally known to me, who, being by me duly sworn, severally said tha~ 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 majority of the same; that they knew the corporate seal of ~id 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 s~ned his name thereto as .a Trustee and by like order. :...:- ,. ......... FOl~ NO. 1 TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ...... ............................... Approved ~,~,-~-~¢z ....... ~..~/~¢/.,~-~..~. .......... : .......... Permit No ....... .~.....~....~. ................. Disapproved a//E .................................... ...~~~.-. ............................................................................... .............................. ~,-b'/' ( .]~,~-'~__~;~._chairmon, Board of Trustees / APPLICATION FOR PERMIT INSTRUCTIONS A. This application to be completely filled in by typewriter or in ink and submi~ed to the Town Trustees in, duplieate. 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 proje~ct must be drawn on. diagram which is part of this appli- cation. 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 she 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 perrrdt. 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 la~vs, ordinances and regulations governing construction of: docks, piers, bulkheads, ]ettys and dredging in; under, and over the waters of Town of Southold. The applicant agrees to comply with all appli- cable laws, ordinances, regulations and conditions specified by said trustees, and to hold the Zown~ of Southold, and all Town officials free from liability and damages of any kind. // Name of owner of premises ..S~..~...C~.~......~..~..~....,~.,'~/~....~.P...O..~...~Z~..C.£.Z~.. ................................................................... Street Address of Property ..... E..~.C .....~...~...c~.. Home Address f Other Than Location ....-? ................................................................................................................... Creek, Bay or Harbor Fronting Property ....~..9.~.~.-~ Permit Requested To: .....~..~..~.C~.¢.-. .......................................................................................................................................... Size of Proposed Work: Length ..... ./.0..0.....~..-~.., ....... Width ............................ Heighth Above High Water ............................ Depth Below Low Water .......................... Average Rise In Tide .......................... Yards To Be Excavated .......................... Width of Canal, Creek or Bay Fronting Property .......................................... Depth at Low Tide .......................................... s This For Private or Business Use? ...~gJ.Y.~ .~.~ .................................... Area Zoning ........................................................ Complete plot plan to be drawn on reverse side of this application. STATE OF NEW yORK) ............... ~~~..u~...... being duly sworn, deposes and says that he is the applicant for the above described permit, aKd that all ~t~ements 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 applioation and as ~proved by the Board of Trustees of the:Town of Southold, and the applicant agrees to hold the Town of Southold and said trustees harmless and free from any a~d all damage~ and arising under or by virtue of said permit. Notary P~lic ~ ............... ~ ........... County o~~ IUDIT~ T. ~KEN ~t~ P~blic. State of New York ~V~ KTt4