HomeMy WebLinkAboutTR-85 TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
NO.
Pursuant to the provisions of Chapter 615 of the Laws of 1893 of the State of
New York and Chopter 404 of the Laws of ]952 of the State of New York and in accordance
with the resolution of the Board of Trustees of the Town of Southold adopted at a meeting
of said Board on ....~]~e~...2~...1~5~. ............. and in consideration of the sum of
$ ......... 15,,.g.g. ....... ,.., lawful money of the United States, paid
residing at ......... ~.ln%..~,~..~g~c%¢...C~.c~OcJtz~-~....L~.I.,. ...................., New York,
the said Board of Trustees of the Town of Southold, Suffolk County, New York, hereby
authorizes and permits said .Q~;i~...c~.~...V..~...&.~m%tZ;k~....V.~...~.g~,.~.~ ..................to
to clre~ge t~e m~a~ow and ~ater in t~e c~eek in front of
~eir ~roperty (Lot Wi5} on Little Creek, All in accordance
wit~ plans submitted ~ith the application~
The said ...£i~Z~..~,...&.,~.i~,..~%~...~?z~t~rt 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 indirectJy as a result of any operation carried on under and pursuant to this
permit, and wHt 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
soid Board of Trustees and the Town of Southold,
THIS PERMI'I' 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 af Sauthaid has
caused its corporate seal to be hereunto affixed and these presents to be subscribed by
a major ty of the said Board of Trustees. the day and year above written.
.......
..... 5.)
STAT[ OF N~~ YOR~
SS:
COUN~ OF SUFFOL~
Of Ori~t~ ~ ~d ~v~ Gold~i~ of ~o~thold,ai~onaHv known
fo me, who, being by me duly sworn, severally said that they each resided in the Town
of 5outhold, County of Suffolk, State of New York, and were members of ihe Boar8 of
Trustees of said Town of Southold and constituted a ma]orify of the same; that they
knew the corporate seal of said Town of SouthoJd; that the seal affixed to the fb~egoJ~g
instrument was such corporate seal; that it was so affixed thereunto by order b? the
~oard of Trustees of said Town of SouthoJd and that each one signed his name there~ as
a Trustee and by like order.
Bay Aw~ue TOWN OF SOUTHOLD
'r -- - ' BOARD OFTOWN TRUSTEES I ~5
· TOWN CLERK'S OFFICE
SOUTHOLD, N. Y,
E amined. .. .......... App cat, ou
DisapproVed ~/c ........................................................................................................................................................................................................................................................
........................... ~~~~ ........ ~m~., ~oara o~
APPLICATION FOR PER~IT
~. Th~s ~p~1~ca~i~n tc be completely fi~ed in by type~'iter or ~ ink ~nd sub~tte~ to th~ To~ ~s.tees ~
~cat~.
B. ~t ~lan showing ~oca~n ~ ~t and b~ngs on pr~s, rela~i~ t~ adjo~ing premises~ pubic s~eets,
pa~ks, ~tc., ~ ~ving detailed description of pr~p~s~ l~yo,ut of pro~ect m~t be ~a~ o~. dia~am which is p~ ~f
th~s a~p~ca~ion.
C. Th~ ~or~ ccvere~ by ~h~ application ~uay ~ot ~ co~n~d b~f~r~ th~ issuance, of ~ ~er~t.
D~ Upon a~prnv~ o~ ~is a.pp~c~icn, T~W~ Truste~.~ w~ ~s~ue a petit to app~cant. S~ch permi~ sh~ be kept
~n ~he ~r~e~ and ~va~a~le for in~c~on ~t a~
~. ~p~c~n~ ~h~1 no~i~y the. Bcar~ ~f ~te~s up~. co~p~t~ o~ th~ ~or~ ccw~ed ~y pe~t.
APPLICaTiON ~S HEREBY ~AD~ ~o ~he Bo,~d of T~tees of the To~n o~ So~ho~d, S~folk Co.unty, New
fo~ ~he. issuance o~ a pe~t p~su~t to the ~mws~ Ordnances and regu~tions governing construction of: d~ks,
piers, bu~eads, jettys ~d ~e,d~g in; u~der, and over the ~ters of Town of Somth,]d. The app~cant a~ees
to comply ~h ~ ~ppHc~b~e~ ~a.ws, or'~anc~s, r'egulatlo~s a~ con~t~ons specified by s~d trustees, and to
~he Town ~ Scutho~d, ~d a~ ~o~ o~c~ls free ~ro.m ~b~ty ~d damages o.f ~y ~n~.
Name o.f owner of premises ~ ~ ~ ~.~~....~._.....~ .. ~.~ ..........
~ree.t Ad,ess of Pro.pe~t~ ~ ~ ~
Home address ~ Other Th~ ~
Cree.k, Bay 0r H~rbor Fronting Proper$~
Pe~t ReqUested
Depth Below Lo~ Wa~er ~.~.~_~... Average Rise in T~de~ Yards to Be
Width of Canal Creek or Ba~ Fr,n,ting Property .............. .~ ............................... Depth at Low ~de.
......................
Is T~s For P~vmte or Business Use~ ~~ . ~rea Zoning .._~
Coznplete plbt plan to be drawn on reverse side of this applicaHon. / ~
STATE OF i~W YORK)
)S. S. :
COUNTY OF )
.................................................................................. being duly sworn, deposes and says that he is the applican~ for the abo~e
sc~bed permit, and that all sta~.ements contained herein are true to the best of his knowledge and belief; that
work v~ll be done in the, manner set forth in the applicatioz and as approved by the Board o~ Trustees of the Town
o~ Southold, and the applican~ agrees to hold the Town Of Southold and said trustees harmless aud fre~e from any
a~d all damages and claims a~ising under or by virtue of sa~d pe~ 1~- ~
(applicant)
Sworn ~o before me this ............................. day of .............................. 19 .............
NoSary public .................................... county of ...................................