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HomeMy WebLinkAboutTR-252 TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES PERIMIT NO ...... ~...~. ~ Pursuant to the provisions of Chapter 615 of the Laws of ]893 of the State of New York and Chapter 404 of the Lows of ] 952 of the State of ~New York and in accordc~nce with the resolution of the Board of Trustees of the Town of Southold adopted at a meeting of said Board on,,..~.O,,¥.~...2.,7..x..,~..~..~..3.. ................. and-in consideration of the sum of $..~.0.~...0~. ,., lawful money of the United States, paid by.....~.~.,.....G,~h..~.~Z,..,~..~:..'. ........ residing at ............ ,..~,....,..C~....~......~..a~.._~.~....~.,~.~,.Q~...,e..~.....~...,;.~..,. ...................... , New York, the said Beard of TrUstees of the Town of Southold, Suffolk County, New York, hereby n' r its said Ra~ G~.. ~, ~., . ..... authorizes a ape m ................................................................. ~ .......... : ...... to The said ...... 3~iL~.~G.~.,~.:~--l';¢ ....................... , os 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 suitethat rnoy ariseor occur directly or indirectly as a result of any operation carried on under and pursuant to this permit, andwill at his own expense, defend any and all suits which may bebrought by third parties os a result of any operation carried on pursuant roar 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 conditians~ 1. 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 Iow and high wateF mark. 3. That the work shall be subject to the supervision and approval o~ fha said Board of Trustees or ifs 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.) STATE OF NEW YORK ) SS: COUNTY OF SUFFOLK ) 3'141c: '~'~'~ .--I,.,.,, ~f ~"~"~-'-~d 1o ~c=r before me personally appeared ~ ~at~w ~ ~ ~T~ J~[~.~r, all personally known to me, who. being by me duly sworn~ severally said that they each res[d~ in the TOwn of S0uthold. ~un~ of Suffolk, State o~ New YorE, and were members of the~ Board o~ Trustees of said T~n of Southold and constituted o mojori~ of the ~me; that they Enew the corporate seal o~ said Town of Southold; that the seal o~fi~d to the foregoing instrument was such co.orate seal; thor it was so offlxed thereunto b~ order of the Board of Trustees of said Town of Southold and that each one sign~ his name thereto os o Trustee and by like order. FO~ ~0. I TOWN OF SOUTHOLD BOARD OF TOWN' TRUSTEES TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ..~~..,..,.,~~ ...................... Permit No .........%~...~ .............. Disapprove~oda/c/ ..................................... .......................... .~../~ . ................................................................................. ............................. ~x~....~.....~,,~s~F~¢,~hoirmon,//"/' Board of Trustees / APPLICATION FOR.PERMIT / INSTRUCTIONS A. This application to be completely filled in by typewriter or in ink and submitted to the Town Trustees inr duplicate. B. Plot plan showing location of lot and buildings on premises, relation to adjoining premises, public streets, perks, etc., and giving detailed description of proposed layout of project must be drawn o~ diagram which is part of this appli- cation. C. The work covered by this application may nat be commenced before the issuance of a permit. D. Upon approval of this application, Town Trustees will issue o permit to applicant. Such permit shall be kept on the premises and available for 'nspection at orll times. E. Applicant shall notify the Board of Trustees upon completion of the work covered by permit. APPLICATION IS HEREBY MADE to the Board of Trustees of the Town of Southold, Suffolk County, New York, for the ~ssuance of a permit pursuant to the lows, ordinances and. regulations governing construction of: docks, piers, bulkheads, jettys 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'r to hold the Town of Southold, and off Town officials free from liability and damages of any kind. Name of owner of premises ...... .~.`.?:}~...~..~.~9.~?`~`..~.e..e~:~22z...~..~..:~:~...G~:~...~.~2~.q3&~%¢`~.2~`3`]~.%}L.~.~.~g ............................ Address of Property ...... ~...~.z~.~..~.~.~.~.~D.~.~:.J.`?L~]`~¢~p.~1~.~`~.~. .................................................. if Other Than Location ....... ~..O...~.O.~..p.,e.x~..yx~;i.~.~...~.?,~.~D.~..~,,...~(o.Z ....................................................... or Harbor Fronting Property ~`~`q~`9.~.q.~.~4~.~.~.~.~?~i`~..Q.~i~.~.a.~i~`j~t .......................... Requested To: ........... .?. ~_.~..e. ~.~ ~....~.~?jg... ~ ~c..~.~ ............................................................................................................ ;ize of Proposed Work: Length ..3,.g.C.Q~;...ff~ ........ Width ,...$0~..h?¢ ......... Heighth Above High Water....D¢.¢~ ............... Below Low Water ................ ~..~,. Average R~se In Tide ....... 2...~:s ......... Yards To Be Excavated ,.2.OO.~.OD.Q ....... of Canal, Creek or Bay Fronting Property .......................................... Depth at Low Tide .......................................... ~ This For Private or Business Use? ........... ~.~&F¢~.P,.%.~P ............................ Area Zoning ~q ................................................ ;omplete plot plan to be drawn on reverse side of this application. 'ATE OF N~V YORK) S.S. )UNTY OF .~...~.q:.~ .. being duly sworn, de.poses and says that he is the applicant for fh~ ~bove descr bed m t, and that a I statements contained herein are true to tne best of h s know edge and be ief; that the work w~ I be done the manner set forth in the appJica.tlon and as approved by the Board of Trustees of the:Town of Southold, and the ~licant agrees to hold the Town of $outhold and sa.id trustees harmless and free from any a~d oil damages and cia rms applicant) to b*~oro me th~s ............. d~y o{ ....~.~.~ ....... 19..~._. Residino i~ Suffolk County / / / SOU'I-HOLD -- ~:~AYVIEW i $,5~JE, ID BY'