HomeMy WebLinkAboutTR-38-2-34Board Of $outhold Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO. 2~'~g-~ ~/ DATE:
ISSUED TO ..... '~ g.~ ~..~,~ ~ -.'c.~:~ n; .........
Authorization
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York, 1893; and Chapter 404 of the L.aws of the
State of New York 1952; and the Southold Town Or&nance 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
Resolution of The Board adopted at a meeting held on lac
19 and in consideration of the sum of $ ~×~ paid by
of N.Y. and subject to the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the following:
all in accordance with the detai~ed specifications as presented in
the originating application.
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes its Corporate Seal to be affixed, and these presents to
be subscribed by a majority of the said Board as of this date.
Trustees
TRUSTEES
John M. Bredemeyer, III, President
Henry P. Smith, Vice President
Albert J. Krupski, Jr.
John L. Bednoski, Jr.
John B. Tuthill
Telephone (516) 765-1892
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
GRANDFATHER APPLICATION
Address of Property:
Tax Map N~ber: 1000-
Tel. NO: %T7 ' 9&SG
Approx.yr.of construct:
Prior owner if known: .-~4~rg,~?p~..~J~,~-P_ k~ ~_%~
Diagram of existing structures, including all dimensions, must be
included with this application:
Indicate on attached map: Location, ie; reference point, telephone
pole number, adjacent property owners, etc.
Signature of applicant: ~ ~"~ ~{k"~ Date: l~J" ~_~'
Please note, there is a one time fee of $50.00 for filing this
application.