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Board Of Southold Town Trustees �Y
SOUTHOLD, NEW YORK --
s.. 699 A ri.1 3 1972
PERMIT NO. .................... ........... DATE: ... P..... .... .t.......
ISSUED TO .Fisherman ' s Beach Association
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Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York, 1893; and Chapter 404 of the Laws of the
State of New York 1952; and the Southold Town Ordinance en-
titled "REGULATING AND THE PLACING OF OBSTRUCTIONS `
IN AND ON. TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and in accordance with the
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Resolution of The Board adopted at a meeting held on Apri1.....3
19.72...., and in consideration of the sum of $no fee....... paid 6y
Fisherman's Beach Association
of Broadwaters", Cutchogue" N. Y. and subject to the
Terms and Conditions listed- on the reverse side hereof,
of Southold Town Trustees authorizes and permits the following:
maintenance dredging of channel 100 ft. by 4 ft.
at Fisherman" s Beach on ,Broadwaters. Creek, . Hay
waters Road, Cutchogue, N.Y. ,
:., all in accordance with the detailed specifications as presented in
the originating applcation.
IN WITNESS WHEREOF, The said Board of Trustees here-`
R 6y causes its Corporate Seal to 6e affixed, and these presents to ,
6e subscribed 6y a majority of the said Board as of this date.
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TERMS and CONDITIONS
The Permittee Fisherman's Beach Association
residing at Haywaters Road, Cutchogue, N. Y, as
part of the consideration for the issuance of .the Permit does understand and prescribe to the fol-
lowing:
1. That the said.Board of Trustees and the Town of Southold are released from any and
all damages, or claims for damages, of suits arising directly or.indirectly as a result of any oper-
ation pe.formed pursuant to this permit, and the said Permittee,will, at his or.her own expense,
defend any and all such suits initiated by third parties, and the said Permittee assumes.full liability .
with respect thereto, to the complete exclusion of the Board of.Trustees of the Town of Southold
2. That this Permit is valid for a period of 12 mos. which is considered to be the
estimated time required to complete the work involved, but should circumstances warrant, request
for an extension may be made to the Board at a later date.
3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes
to rnaintain the structure or project involved, to provide evidence to anyone concerned that auth-
orization was originally obtained.
4. That the work involved will be subject to the inspection and approval of the Board or
its agents, and non-compliance with the provisions of the originating application,,may be-cause for `
revocation of this Permit by resolution of the said Board.
5. That there will be no unreasonable interference with navigation as a result of the work
herein authorized.
6. That there shall be no interference with the right of the public to pass and repass along
the beach between high and low water marks.
7. That if future operations of the Town of Southold require the removal and/or alterations
in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the
work shall cause unreasonable obstruction to free navigation, the said Permittee will be required,
{ i upon due notice, to remove or alter this work or project herein stated without expenses to the Town•
of Southold.
8. That the said Board will be notified by the Permittee of the completion of the work auth-
orized.
9. That the Permittee will obtain all other permits and,consents-that may be required sup-
plemental to this permit which may be subject to revoke upon Failure to obtain. same.
FORM NO. 1
TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined . . . . . ... . . .. . . .. .. .... . . .. . . .. . . . 19 . .. .. Application No. . . . . . .. .. .. .. . . .. .
Approved kd .3 - ... .. . . .. . . .. . .... . . . Permit No. .. .. .. .. . . .. . . .
,�,
Disapproved a/c . . . .. . . .. .. .. . . . . .. . . . . . . . . .. rf.. .. . . . . . . . ... . . . . . . . . . . .
. .. .. . . . chairman, Board of Trustees s tees
.. .
APPLICATION FOR PERMIT_
INSTRUCTIONS
A. This application to 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 giving 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 to applicant. Such permit shall be kept on
the premises and available for inspection at all 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 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 from liability and damages of any kind.
Name of Owner of Premises
/&)4
Street Address of Property . .. ... . . . . . . . . . . . . . . .
. . .. . . . . ..... . . . . . . . .. . . .. . . . . .. . .
Home Address If Other, Than Location A(,u . . . .. Lh 14&A . ......... . .. . . . . . . .
041,9
Creek, Bay or Harbor Fronting Property A . . .. . . . .. . . . .. . . . . . . . ...... .. . . .. .. . . . . . . .. . . . .. . . .. . .
Permits Requested To: . .. . . .. .. .. .. . . ... . .. . . .. .. . . .... . .. . . .. .. .. .. .. . . .. ..... .. .. . . . . . . . . . . . .
0 /
Size of Proposed Work: Length . . .. . . .. . . . Width . ..6. . . .. .. . Heighth Above High Water .. . . . . . . .
f
AJ- ... .. .. . . . .. .. .
Depth Below Low Water . . . Average Rise In Tide . .. .13. . Yards to Be Excavated C
Width of Canal, Creek or Bay Fronting Property,. .. /,00...... . . .. .. . . .. . Depth at Low Tide . .0?..... .. .. .. . . .. .
Is This For Private or Business Use? .. .. .. . . . .. . . . .. . . . . . .. . . Area Zoning . .. .. .. . . .. .. . . . . ...
. . .
Complete plot plan to be-drawn omreverse side of this application. . .
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6.
To AkQu, ,w 6eacle-
STATE OF NEW YORK
COUNTY OF
. . . . . .. .. ... . . . .
. .. . . . . .. . being duly sworn deposes and says that he is the applicant for the above described
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 harmless and free from any and
all damages and claims arising under or by virtue of said permit.
(applicant)
Sworn to before me this . .. .. day of . . . . . . .
Notary public Ow . . . . . . c ny of
/.I- JOSEPH G. SHIELDS.
Notary Public.State of New York
No.41-8973550
Qua
in Queens County
Expires March 30, 1972
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