HomeMy WebLinkAboutTR-410TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
PERMIT NO. ~///j
Pursuant to the provisions of Chapter 615 of the Lows of 1893 of the Store of
New York and Chapter 404 of the Laws of t 952 of the State of New York and in occordance
with the resolution of the Board of Trustees of the Town of Southold adopted at a meeting
of said Board on ,.:....~z~.~mZ~ez:..~_.,~..o~6~ .......... and in consideration of the sum of
$ ....... 2.0~Jg0 .............. lawful money of the United States, paid by
residing at .......Z~e.~_~u££~],~..~t~.~...~¢¢~%~k.;....T~.][.~ ................. , New York,
the ~aid Boo~d of Trustees of the Town of Southold, Suffolk County, New York, hereby
authorizes and permits said ............. ~.~.q~.e....~.,...~.~...Z~[ ................................... to
erect a dock and float in Deep ~ole Creek, Mattituek~
ai~ in accor~anc~ ~i%h the application s~bmitted.
The said ....~.qr.¢~...~,...~'~_~...,~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 al! 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 ¢o this
permit, end wi!l at his awn expense, defend an7 and all suits which may be brought by third
parties as a result of ony operation carried on pursuant to or in accordance with the terms of
this permff, and assume full Biability with respect thereto '~o the complete exclusion, of
said Boord of Trustees and t~e 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
wor~ herein authorized.
2. That there shall be no interference with the right of the public to pass and ['epass
along that portion of the beach between !ow and high water mark.
That the work shall be subiect to the supervision and approval of the said Board of
Trustees or its agents.
1N 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
S.)
S.)
(L. S.)
(L. S.)
STATE OF NEW YORK )
SS:
COUNTY OF SUFFOLK )
ON THIS.....~.z,~..,.day of ........ 4)e.~e~ez' ............................. , 19...6~.,.., before me
personally appeared Alv&h Bo Gol~¢mi~ F~a~ Daemon, John F~
~c~ulty~ ~eorge Simpson and ~glaa RoDertson ~ all pe~onaJly know¢
tO me, who. being by me duly sworn, severally sa~d that they each resided in the Town
of Southo]d CounW of Suffolk, State of New York, and were members of the Board of
Trustees of said Town of Southo]d and constituted a m¢jori~ of the same; that they
knew the corporate seal of said Town of SouthoJd; 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 Southoid and that each one signed his name thereto as
a Trustee and by tike order.
Not~ Public
FO~ NO. I
TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ...... _...,,..; .~. ........... 19 ...... Application No ..................
Approved ................................... -~ Permit No ..... ~ f...~. ...............
Disapproved a/c ~
........................ chairman, Board of Trustees
APPLICATION FOR PERMIT
INSTRUCTIONS
A. This application to be completely filled in by wpewriter or in ink and submitted to the Town Trustees in dup-
licate.
B. Plot plan showing location of lot and buildings on premises, relation ro adjoining premises, public streets,
parks, etc., and giving detailed description of proposed layout of projecl musr 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 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 ail times.
E. Applicant shall notify the Board of Trustees upon completion of %he wor!~ 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, jettys and dredging in, under, and o*Ver the waters of To,Tvn of Southold. The applicant agrees
to comply with ali applicable laws, ordinances, regulations and conditions specified by said trustees~ and to hold
the Town of Southold, and all Town officials free from liability .a~d damages of any kind.
Name of owner of premises ........... L~%..~. ?z~.~. .~....~... ?"....].¥..'C..¥~..>¢.'....5~ ..............................
Stree~ Address of Property .................. '].: .~.'.~.i .,~.~.~....{(~.~..$ ....... .~ ......................................
Home address If Other Than Location . f.~/..~. :..~.,~.. ~' .A /~ ~
........ ?. ...... .<. ................................
Creek, Bay or Harbor Front~ng~Property .. L~,~.q. ¥-. ?}. ~.~..% .~.. r.~... ~ 2~. .~..~..'./x...~.'...C...~..~... ~.~.. ~.~?....~.~..*..~..~...(.5.)
Permit Requested To: ...... .~.~: .~.~. ..... ("/5 ..... ~ .... '~' '~ '~' ' ' ' ! '~ l..~. ~ .~.. ...................................
Size of Proposed Work: Length .... C(.?....~.q.....Width .... ~..-~.~..~....Heighth Above High Water../.../~...~.~.
Depth Below Low Water .... 2..?..~. ..... Average Rise In Tide. ? '(:+' . .Yards to Be Excavated ..... .-7......
Width of Canal, Creek or Bay Fronting Property .... .~?..~.... ~?.."f-. .... Depth at Low Tide ..... .~....~?..~. .......
Is This For Private or Business Use? ......... .~..~...3.' ................. Area Zoning ........ f~ ...............
Complete plot plan ro be drawn on reverse side of this application.
STATE OF NEW YORK )
)s.s.
COUNTY OF,~,if~j/<.._.~ .. )
· ~:~'/'~' :''"~'~7 .... ....... being duly sworn deposes and says that he is the applicant for the above de-
scribed permit, and that all statements contained herein are true to the best of his knowledge and belief; that the
work will he 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 Southold and said trustees harmless and free from any
Sworn to before me this. ~. A ...... day of .... ~.V, ~..~... 19. ~.~.
Notary pub~/~Y: ......... unry
[ BARbArA A.'CA~ .... ; ..............
No. 52-55fi9890
Go~;~on ~p!es March 30,