HomeMy WebLinkAboutTR-76 TOWN OF SOUTHO/D
BOARD OF TOWN TRUSTEES
NO ....... ....
Pursuant to the provisions of Chapter 615 of the Laws of 1893 of the State of
New York and Chapter 404 of the Laws of J952 of the State of New York and in accordance
with the resolution af the Board of Trustees of the Town of Southold adopted at a meet[nfl
of said Board on ...... ¢~s%...3~,.,3,~5.~ .................. and in consideration of the sum of
$ ...... ~Q.,.Q~ .............. lawful money of the United States, paid by
residing at .............. ~n~.~..~.~z.~...~-~;...~.~.~...c~,C,~lew York,
the said Board of Trustees of the Town of Southoid, Suffolk County, New York, hereby
authorizes and permits said '~ ~ ~,~ ~ ~ ~
.......... ~.,.0~ ·. ~. ~ ·, -~. · · ~,~ ~.~ '~ .................................................. ~0
7 f~et ~ide~ all in accord, anc~ with the application
s~b~%itted ~
The said ......... E~...E.~...~¢.~¢~?~.~ ......................... , as part of the cons~derat.ion
for the issuance of this permit does hereby re~ease the said Board of Trustees and
Town af Sautheld {ram any and al! damages claims ~er damages or suits that may orise'\or
occur directly or indirect[y as a result of any operation carried on under and pursuant to thJ'~
permit, and wiiJ 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:
1, That there shah 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 punic to pass and repass
along that portion of the be,ach between Iow and high water mark.
3. That the work shall 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.
sea,
..~i,~f ~..<C, ..... ~. ...... ~ ................. ~ S.) :
STATE OF NEW YORK )
SS:
COUNTY OF SUFFOLK )
ON THIS ..... .~'~-~..t~...~]'~y of ............. ~.,.~.~.~.,~ .................... , 1,~9..,..~..., before ~e
a{J personaJJy knOWn
¢o m~, who, being b~ me duJy sworn, severally said that they each resided Jn the T6wn
of 5gutho]d, County of Sulfa(k, State of New York, and were members of the Boar~ of
Trustees of ssJd Town of Southo]d and constituted a majority of ¢he same; %hct ~hey
knew .he corporate seuJ of sa[d iown of Sou¢ho]d; that ¢he seal affixed to ¢he ,ore~bln~
instrumen~ was such corpora¢s seal; that i~ was so affixed thereunto by order o~' ?he
Bo~.rd of Trustees of said Town of SouthoJd and ¢ha¢ each one signed his name there~o cs
a ~tus~ee and by like oraer. '
N~..52G3449~3, ~ff~k
TOWN OF SOUT. HOLD
h
BOARD OF TOWN TRUSTEES ,'~",
A~oved
/
/~ APPLICATION FOR PERMIT
IN~TR~OiT~O.N~
A. This application to be completely fi~ed in by type~-iter o[- M ink and submitted to the Town ~tees in dup-
B. Plot plan showing location of lot a.nd buffings o~ premises, rela.tio~ to adjoining premises, pubic: s~ree~s,
paz-ks, etc., and giving detailed description o.f p~opose~ layout of project must be dra~. on ~agra,m wMch is pa~ of
this a,pP~c~tion.
O, The work covered by this application may not Be commenced before the issnance of a ~ermB.
D. Upon approval of this a.pp]ica~ion., Town Trustees wiB issue a permit to applicant. Such p,ermB sha~ be kept
o~ the premises and available for inspection at ~ times.
:E. Ap~ca.nt sha~ notify the. Board o.f T~mtees npon co~p!etion of the work cove~e~ by
APPLICATION I~ H~RE.BY MADE ~o the Board of ~ustees 0f the Town of So~thoZd, S~ffolk C~o~ty, New York,
for the. issuance 0~ a pe.rm~ p~'sua~t to the laws, Ordinances and regntations &overuing construc~on ~f: docks,
piers, bul~ea,ds, jett~ and d~edCng in; nnder', and over' the ~ters of To~ of Sou~tho]d. The applicant agrees
to, comply ~h a~ applzcable; lawS, e~dJ~a.nces, re.~latzo.ns and conditions specified by s.a~d trustee,s, and to hold
the Town o,f Southold, and a~ To~ o~cia~ free from liability and dama~'es o.f any kMd. .
8~ge of Proposed Work: Length ~_.~......~ ............. ~d~h ....... J~ ....................... ~ ~mghtR Above, Hxgh Wate~ .....~. ........................
~epth, Below Low Water ......... t.~ ......... Average Rise ~n~d~ ....... ~...~ ............ Y~rds to Be Excavated ..... ~~ ....
Oom~lete plot ~l;n to be dr;~ on reverse s~de o~ ~his ~plio~tion.
STATE OF NEW YORK)
~ ~ )S.S.
COUNTY OF~. ) ////.._
scri~e~l~~ ~'perr~it, and their all st~ements co.ntsfined herein ire true to the best of his k~o,wledge' and belief; that the
work will be done in the manner set forth in the. application, and as approved by the. Board o~ Trustees of the Town
of S.outhold, a~d the applioant agrees ~o hold the Town df Southold and said trustees harmless aud free from any
and all damages a.nd ~laims a~ising under' or by virtue o.f said per~t. _
~otary P',~blic, State of New Yor~
No. 52-0344963, Suffolk County