HomeMy WebLinkAboutTR-210 TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
PER~VUT NO. ~ ! ~
Pursuant to the provisions of Chapter 615 of the Lows 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 o meeting
of said Board on......~..q~..~.3 ....2...~.~....[.9...6..~ ................ , and in consideration of the sum of
$;~5,..O~..., lawful money of the United States, paid by...~...~,..*....~g.~.~,.e...~..e..~.. ..............
residing at ........ C~l~e~,s..~O~3:~...~r.~e~;~3~.t,...~.~,..,a~ ............... , New York,
4011 209~,h St.~ ~&Ysi~e, L.I.
the said B~rd of Trustees of the Town of ~uthold, Suffolk County, New York, hereby
authorizes and permits said ......... ~.~.~..~,...~ ............................................... to
b~l~e~ ~d ~g~ hi~ ~ ~o~er~y ~ ~ ~ron~ of his
~y ~o co~ct wl~ ~e c~nne!, all ~ acc~d~ce
The said ,..~.~;.L...~.?...~.C.'.~...~..~..~.~..~.. .............................. os part of the consideration
for the issuance of this permit does hereby release the said Board of Trustees and the
i 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 oil suits which may be brought by thir~
parties as a result of any operation carried an 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 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 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 seai to be hereunto affixed and these presents to be subscribed by
a majority of the said Board of Trustees, above written.
seal [L. S.)
..(k S.)
,..(k S.)
............................................................ (L. S.)
STATE OF NEW YORK
SS:
COUNTY OF SUFFOLK )
ON THIS....~ ....... day of .........................................................~=~[I~ fJ 19.~.., before me
personally appeared ~
JO~ ~t[y and Alv~ Gold~ all personally known
~o me, who, being by me duly sworn, severally said ~at they each resided in the Town
of ~uthold, County of Suffolk, State of New York, and were members of the Board of
Trustees of said Town of Southold and constituted e majori~ of the same; that they
knew the corporate seal of said 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~gned his name thereto as
a Trustee and by like order.
~_ 'p~, // /~ ~ No~ ~ublic
- ~
FORM NO· 1
TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined . .~f_~. ~. ~. ............... 19 ~( z~.. Application No .................
Disapprovej~/c*/" .................... ~. ...... ~ .......................................................
× APPLICATION FOR PEP, MIT
./
INSTRUCTIONS
A. This application ro be completely filled in by typewriter or in ink and submitted to the Town Trustees in dup-
licate.
B. Plot plan showing location of lot and buildings on premises, relation to adjoining premises, public streets:
parks, etc., and gl'zing detailed description of proposed layout of project must 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 ro applicant. Such permit shall be kept
on the premises and available for inspection ar all times.
E. Applicant shall notify the Board of Trustees upon completion of the work covered by permit.
APPLICATION IS HEREBY MADE ro 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 over the waters of Town of Southold. The applicant agrees
to comply with all applicable laws. ordinances, regulations and conditions specified by said trustees, and to hold
the Town of Southold. and all Town officials free [rom liability and damages of any kind.
Name Of owner of premises ...gg.~. ~. 6. ~.O~t~. ...... · ................................................
Home ~ddress If Other Than Location ...4O[l,t...~fig~h..St...~..Bays&de :. ~., .~ ...........................
Creek, Bay or Harbor Fronting Property ~u.~_. ~,~ ..........................................................
Permit Requested To: . .QCt~t~c}. ~f0~c~. ~lradge ...........................................................
Size of i Proposed Work: Length .................. Width .............. Heighth Above High Water. ' ...... ,,...
Depth ~3elow Low Water ................ Average Rise In Tide .............. Yards to Be Excavated.
Width of Canal, Creek or Bay Fronting Property ...................... Depth at Low Tide .....................
ts This For Private or Business Use? .... ~.~, .......................... Area Zoning .~e~.~.~e:~.t_~ ..........
Complete plot plan to be drawn on reverse side of this application.
STATE OF NEW YORK )
)s.s.
................
· b m I
.................... e g du y 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 be 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 harmles~ and free from any
and all damages and claims arising under or by virtue of said permit.
~ 7 ;/ (applica~)
Sworn to before m~th~s ..... ~ ........ day o{..(~fi~ .... 19.~.~. ~'
Notary publi unts of. .....~ ......
[~[~, S~te of New York
~m~tSSlO~ Expires March 30, 19,~
!~roposed Bui!aheads and D~edgimg ·
ua~_ ~. Sehaefe~
Ail constructiom withim the property limes~ with
the exoe~tiom_ o~ tZze a mooring piles amd the
dredgin~ ~ecsssary to cop~e~t with the oha~mel,