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Home My WebLink AboutSCHILD, EDWARD M FO~ NO. 1 TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................................ 19 ............ Application No ............................. Approved ............................................................................... Permit No ....................................... Disapproved a/c ....................................................................................................................................................................... ................................................................................ chairman, Board of Trustees APPLICATION FOB PERMIT INSTRUCTIONS This application to be comp etely filled in by typewriter or in ink and submitted to the Town Trustees in duplicate. Plot plan showing location of lot and build,ings on premise~, relation to adjoining premises, public streets~rksyetc., and giving detailed description o~ pr-opo~ed 'layout of-project must be drawn or~ diagram which is part of this appJi'--' cation. 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 e permit to applicant. Such permit shall be kept on the premises and available for inspection at a~]l times. E. Applicant shall notify the Boa.rd of Trustees upon comgletion of the work covered by permit. APPLICATION IS HEREBY MADE to the Board of Trustees of the Town of Southold, Suffolk Cdunty, New York. for the issuance of a permit pursuant to the bvs, ordinances and regulations governing construction of: docks, pier. s, bulkheads, iettys and dredging in; under, and over the waters of Town of Southold. The applicant agrees to comply with ail appli- cable laws, ordinances, regulations and conditions specified by said trustees, and to hold the Town of Southold, and all Town officials free from liability and damages of any kind. Name of owner of premises Street Address of Property Home Address If Oiher Than Location .......... .~'...'.;~....,L~J,~.~..'.'.J~.~..~..,...~....; .............................................................................. Creek, Bay or Harbor Fronting Property ............ ..~:..~...'_¥L~..- ..................................................................................................... Permit Requested To: ............ · Size of Proposed Work: Length ...... ~.~.~ ............... Width ' ,, Heighth Above High Water ......... ~,; ................ Death Below Low VVater .......................... Average Rise In Tide .......................... Yards To Be Excavated Width of Canal, Creel( or Bay Fronting Property .......................................... Depth at Low Tide ..~. ..................................... Is This For Private or Business Use? ~_5 ...... Area Zoning ........................................................ Complete plot plan to be drawn on reverse side of this application. STATE OF NEW YORK) COUNTY OF~ ...¢~f,~,4~..~....~~( ..... bejng duly sworn, de.pos~s and says that he is the applicator for the ~bove descrlbee permit, and that ali statements contained herein are true to the best of his knowledge end belief; that the work wH~ be done in the moaner set forth in the applic,ation and as approved by the Board of Trustees of th~:Zown of Southold, and the " s~ad · applicant agrees to hoed the Town of Southold and said trustee n free from any and ail damages and claims arising under or by virtue of said permff Lapp.car~ Swam to before me this ..... .;..~. da f .~~.. 19...~.Z.. jc~.h /" '- 3 o FOR1V/NO, 1 TOWN OF $OUTHOLD BOARD OF TOWN TRUSTEES TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................................ ]9 ............ Application No ............................ Approved ............................................................................... Permit No ....................................... Disapproved o/c ....................................................................................................................................................................... ............................................................................... chairman, Board of Trustees APPLICATION FOR PERMIT INSTRUCTIONS A. This application to be completely filled in by typewriter or in ink one submitted to the Town Trustees in, duplicate. B Plot plan showing location of lot and buildings on premises, relation to adjoining premises, public streets, parks, etc., and giving detailed description_ o~ p[OPos~d'lb~u~.?~ip[o]e~ct]m~ ust b! drawn on, diagram which is part of this appli- cation. 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 t6 applicant. Such permit shall be kept on the premises and oval!able for inspection at a~ll times. E. Applicant sha!l 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 issuance of a permit pursuant to the laws, ordinances and regulations governing construction of: docks, piere, bulkheads, ]ettys and dredging in; under, and over the waters of Town of Southold. The applicant agrees to comply with ell appli- cable laws, ordinances, regulations and conditions specified by said trustees, and to hold the Town of SouthoId, and Town officials free from liability and damages of any kind. Name of owner of premises ........ ?.~...~.~..~..~.c.~.~..~.. ................................................................................................................ Street Add,'ess of Property .......... ....................................................................................................... Home Address If Other Than Location ...... ?..o~.~.2..~.~...~.~.?.~.~.o,.~.~?...~}..~..~. ................................................................................ Creek, Bay or Harbor Fronting Property ........ ~$..t..1...~.~..e.9.~. ............................................................................................... Permit Requested To: .... .......................................................................... Size of Proposed Work: Length ....... ~.~.[ ................ Width .......8..! .................. Heighth Above High Water ....... .2.! .................. Depth Below Low Water ...~.~. ................... Average Rise In Tide ..........~?.~. ........ Yards To Be Excavated .... ~.0....c.~ ........... i00 ~ Width of Corral, Creek or Bay Fronting Property ...................................... Depth ct Low Tide .......................................... is This For Private or Business Use? .......... .~.~.~.~ ............................. Area Zoning ....... ~.~.e.~ ................................. Complete plot plan to be drawn on reverse side of this application. STATE OF NEW YORK) )S.$. COUNTY OF ............. .~..,t/...~... '~~..... be, lng duly sworn, deposes and soys that he Js the applicant for fh~ ,above described permit, and that ail statements contained herein are true to the best of his knowledge and belief; that the work will be don~ in the manner set forth in the application and os approved by the Board of Trustees of the. Town of Southoid, and the applicant agrees to hold the Town of Southold and said trustees harm~es~d free from ~ny arid all damages and claims arising unde~ orby virtue of sa~d permit.~ ~~.~~ Sworn to before me this ....~..~.... d~~ .... 19._~.~. (app~cc~ ~AR]ON A. REGENT ~ARY PUBLIC, Sta~e of '~ ~o, 52-3233120 Suffaik Co~r,t~ Ter~ ~Jres ~a~c~ 30,r