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TOWN OF SOUTHOLD
BOARD OF TOWN TRUSTEES
PERMIT NO. . . . . .[ .® � . . . . .
Pursuant to the provisions .of Chapter 615 of the Laws of 1593 of the State
of New York; Chapter 404 of the Laws of 1952 of the State of New York; the pro-
visions of an ordinance entitled "Southold Town Ordinance Regulating 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 resolution of the Board of Trustees of the Town of Southold adopted at a meet-
ing of said Board on . . ...Jtaxle. .7.2,. .],9b.7. . . . . ., and in consideration of the sum
of $. .4$.,00. ., lawful money of the United States, paid by H...Bv d1ey.&. .Ue.1en
residing at .WaitermiaW. Drive. . Southold, L-J... . . . . .. New Yar ,ethe said
Board of Trustees of the Town of Southold, Suffolk County, New York, hereby
authorized and permits said .o Bradley &. Helen !^Ure to
dredge 100 feet x. 50 feet in Goose Creek, , gouthold, all in
accordance with the application submitted.
The said u,Axed(Py.. .&. melim as 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 all damages claims for damages or suits that:
may arise or occur directly or indirectly as a result of any operation carried on un-
der and pursuant to this permit, and will 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 said Board of Trustees .It
and the Town of Southold.
THIS PERMIT is subject to the following terms and conditions:
,E
1. That there shall be no unreasonable interference with navigation as a result of
the work herein authorized.
2. That there shall be no interference with the right of the public to pass and re-
pass along that portion of the beach between low 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.
4. That if future operations of the Town of Southold require the removal and/or
alteration in the location of the work herein authorized, or if, in the opinion
of the Board of Trustees of the Town of Southold, such work ,shall cause un-
reasonable obstruction to free navigation, the said H. ..3ra�1ey. .&:4elen. Moor
will be' required upon due notice from the said Board of Trustees, to remove
or alter the location of the work hereby" authorized without expense to the
Town of Southold, so as to render navigation reasonably free and unobstruct-
ed.
i
The authority conferred by this permit may be terminated by the Board of Trustees
for a failure on the part of the said.. H Br dl.ey..& Helen.Moore..................... to
comply with the terms and conditions herein imposed. In the event of such termination,
this permit shall be deemed revoked five (5) days after the date when the Board of
Trustees shall mail to the said..........#..... ICO.�'.XPY...A,.Helen;,.Moore....... ..... . at the
address given in his application, a certified copy of a resolution of the Board of Trustees
directing such. termination.
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.
[ter Gov
seal ............................................ (L. S.)
.... ............. ............r. ............. (L. S.)
�0..... ............. ...... (L. S.)
STATE OF NEW YORK )
COUNTY OF SUFFOLK )SS:
ON THIS ,,,, 26th;, day of ..........June 67 1
........................................., 19......... before me
personally appeared Alvah B. Goldsmith, Frank Dawson, George
Simpson, John F. McNulty and Douglas Robertson
all personally known
to me, who, being by me duly sworn, severally said that they each resided in the Town
of Southold, County of Suffolk, State of New York, and were members of the Board of
Trustees of said. Town of Southold and constituted a majority 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 signed his name thereto as
a Trustee and by like order.
167 Notary Public
MARIO
NOTARY C A' REGENY
St
No. 52-3233120 Su of New York
Tartu Suffolk Count/
F,xpires .March 30, 19
FORM NO. 1
TOWN OF SOUTHOLD p
BOARD OF TOWN TRUSTEES o,�,� �,
TOWN CLERK'S OFFICE OP rJ 1i67
SOUTHOLD, N. Y. 1,ZQ&. Cl-
Examined . . . . 19. .. ... Application No. . .. .. .. .. .. ..... ..
Approved . .. . . .. .. . ... . . . Permit No. .. .. .. .`-7`J .Q .. ....... . ..
Disapproved a .". ......... .. .... .. .... .... .... .. .. .... ...... . ...
, ,, ,, ,, ,, ,,, , , . . 1. . . .. . . . .. ... chairman, 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 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 .. . H. BRADLEY MOORS, &,HELEN H MOORS, , ,, ,, ,, , , ,, ,, ,,,, ,, ,, ,, ,, ,,,,, ,
Street Address of Property W/S Waterview Dr, ,R , Squ��,Q�c1 ,�T..y.. .. .. .. .... .... .. ........ ..........
Home address If Other Than Location ,34 Harped Drive, CenterpQ tr,,.�T,,.X.. .. .. .. .... .... ........
Creek, Bay or Harbor Fronting ProI)rty Goose Creek a/k/a. G B oose . ay,, ,, ,, ,, ,, ,, ,, ,, ,, ,,,, ,,,, ,, ,,,,
PermitRequested To: . .. .. . .. . . .. . ... .. .. .. . .. . .. . ... . . . .. ... . .. .. . . .. .. .. .. .. .. . . .. .. . . .. .. ..... .
Size of Proposed Work: LeLnJgth. .. .. . . .. . .. .... .Width. ..c._. , . .Heiahth Above High Water....... .... ...
Depth Below Low Water. ..?.tO. F:).. .Average Rise In Tide._ T. .. .Yards to Be Excavated. .. .....
Width of Canal, Creek or Bay Fronting Property. .. .c. Depth at Low Tide .� '.: :. .. .. .... ......
Is This For Private or Business Use? . . P.riva.te. .use. .. .. . . .. . . . . .. .Area Zoning ,R•esidence A.. .... ...
Complete plot plan to be drawn on reverse side of this application.
STATE OF NEW YORK )
)S.S.
COUNTY OF SUFFOLK
. .... .. .. .......
H.. .BRADLEY-MOORE.• •• •• . being duly 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 harmless and free from any
and all damages and claims arising under or by virtue of saitt V ' it.
................ ............
`� (applicant)
Sworn to before me this. .. . . .day of. .. ..Ape i.7... . .. . 19.6.7. . ..
Notary public,_ �... . `. .W . .county of.
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