HomeMy WebLinkAboutTR-57TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
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 1952 of the State of New York and in accordance
with the resolution of the Board of Trustees of the Town of $outhold adopted at o meetJn~
of said Board on .........~.o..¥..e..~.,~.e. ,~....~.~.~,o~.~.~.. .......... and in consideration of the sum of
$....~.~.~..0,.0.. ................ lawful money of the United States, paid by ....~...O..~...~.~.e.....~:...?..~,.~..~.~..
residing at ..... ~,a~..~..~ ~.O.~A~...qA~}J,.O.~:~.~.~..~,*..~. ........................ , New York,
the said Board of Trustees of the Town of Southo[d, Suffolk County, New York, hereby
~uthorizes and permits said ..........~..o..~.~.t.~.~..~.~.,..?..~...e.,i.,~. ................................................. to
dredge a channel in H~ywaters Co~e 200 feet Ir~ len~th~ 15 fe~
in width to a depth of ~ feet below low water~ all in
mecerd~nce with ~ns in a~plz~t~on ~bmi~tedo
The said .... .~.o.A.l.~..e....~.,.....~.~.i.~ ............................. , as part of the consideration
for the issuance of this permit does hereby release the said Board of Trustees and the
Town of Southo[d 'from any and ali damages c!aims 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 ~t his ow~ expense, defend any and a~i suits which may be brought by third
parties as a resuit 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 Southa[d.
THIS PERMIT is subject to the following terms and conditions:
]. That there shall be no unreasonable interference with navigation os 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 [ow 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 co~orate sea] to be hereunto affixed and these presents to be subscribed by
a majority of the said Board of Trusteesr the day end year above written.
seal ,.~:?.-~ ~ ~ '.~. :.~.~ ~:'. ....... .~z~.~. · - ·...~7:.~-. S.)
.................
STATE OF NEW YORK )
SS:
COUNTY OF SUFFOLK )
~pers~nolly'~ appeared E_m~ Dea~ of Gree~po~ N,Y,~ Frank
Weiler~ of Orien~ N.Y~ ~ ~11 persona~y known
to me, who, being by me duly sworn, severally said that they each resided in the Town
of So~thoJd, County of Suffolk, State of New York, and were members of the Beard of
Trustees of said Tow~ of Southo~d end constituted a majoriw of the same; that they
k~ew the corporate seal of said Town of SouthoSd; that the sea~ affixed to the foregoing
~nstrument was such corporate seal; that it was so affixed thereunto by order of the
Board of Trustees of said Town of Southo[d and that each one signed his name thereto as
a Trustee and by like order.
Nota~ Public
I~OF~YVI NO. 1
TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD, [~. Y.
.......................... ~ ........... ~/.~ .... Board of Trustees
APPLICATION FOR PERMIT
INSTi~UCTIO~S
A. This application to be completely filled in by typewriter' or in ink an[[ submitted to the T0.wn. Trustees in dup-
licate.
B. Plot plan showing location og lot and buildings on premises, relation, to adjoining premises) public s~ree~s,
pa~-ks, etc., and giving detailed description of pr~pes.ed ls~vout of project must be draw~ eh. diagram which is pa~t of
this appHca~tion.
C. The work covered by this application may not be commenced before the issuance of a permit.
D. Upon approval of ~s application, Te'~n Trustee~ will issue a permit to applicant. Such p,erm~t shall be kept
on the premises and available, for inspection at all times.
E. Applicator shall notify the Beard of Trt~stees upe~ con'~p!etion of the work covered by permit.
APPLICATION IS H~BE~Y MADE, to the Board of Trustees of the Town of So.~hold, Suffolk C,o,uuty, New
fo~ the, issuance of a pe~t p~ua~t to the laws, OrS~a~ces smd reg~ations goveruing co~truc~on ~f: docks,
piers, bu~eads, jettys ~d ~e.d~ng LU; ~der, and over the ~ers c~ To~ of Sou~t~old. ~e apP~cant agrees
to comply ~th ~ app~cable 1~ws, erdinan.ces, re~.tions a~d conditions specked by said t~stee~, and to hold
the Town ~f SouSheld, and a~ Tc.~ o~c~s free from HabB~y and damages of an~
Name ~f o~er of pre~s~s ............ ~.~_~..~.~ ~_...[~__.~..~J~j.
- ~' ....................... ~ ~. ~,~'"'"'~ ........... : /o-'"~ ........~'~ ~ ~':": ...................... ~" d ' '
~o~e address ~ 0,he~ ~a~ Loca,ion ....... ~.~.....~_~_~.[..~. ............. ~.~ ~...ffO ~ 4..r-... []~.~.-~..~.~.ff~-~., ........................................................
Oreek, ~ay or Harbor Fronting Property __ .~..~'~_~.._....~z.~....~ ............................................................................................................................ ~ ...................................
Pe~it ~equested To: ~.~.f.~-~.fj~g.~i-~.~1-f.~.~..~.~-m---~"X-c.~--.~-~.~.~...-~-~-`...-~-~.~.&L~ .....................
~ize of Proposed Work: Len~h ~_:..~.~.~__... Width .~.~ ............ ; ..... Hei~hih Above High W~ter .._~ ........................
Depth Below Low WaSer ._...~. ................... Average ~ise in Tide ....... ~ ...................... ~ards to Be Excavated .~.~t.L~.~. .........
F on in ....... ...................
..... ..............................
Is ~s Fo~ Private or Business Use? ._~-,..~.~.-..~ .......................... Area
Complete plo~ plan to be dra~ on reverse side of this application. :
STATE '
)s.s.
COUNTY OF ~.._)
................................................................................ b~ Lug duly sworn, deposes and says that he is th~ appliean~ for the above de-
scribed permit, and that all statement contained herein are true to the be~t of his kn,owledge and belief; that the
we~k will be. done in the, manner se~ "or~h in the applicatio~ and as approved by the Board of Trustees of the Town
o.f So.uthold, a~d the applicant agreesI ~o, hold the Town of Southold and said trustees harmless and free from any
and all damages a]ad claims arising un,let or by virtue of said permit./,~ ,'~.~ ~
....... ~.....~_.....~. _ ...........
~ (app~ant)
Sworn ~o be,fore me this ........ ~.~ ............. day of~ 19...~.~. ~/