HomeMy WebLinkAboutTR-E 104-13-6Board Of $outhoid Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO..E... ,.!~ i.:. ~.31.7 J~, DATE: . ):.7~ ! :Cit.~ ....
ISSUED TO ............ ~:,}~.~ ........ ~%~(-~.,...:g ....................................................
Aulh°rizalio
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New York, 189:3; 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, C=RAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and in accordance with the
Resolution of The Board adopted at a meeting held on
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 detailed specifications as presented in
the originating application.
IN WITNESS WHEREOF, The said Board of Trustees kere-
by causes its Corporate Seal to be affixed, and these presents to
be subscribed by a majority of ~he said Board as of this dat,e.
c~.;".:~ ........................ ~ ................. ~'_'u ..................
..: ....... d.. ~.. ~,,~¼i... L,cL~,Z~. ~:~ .......
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
SCOTT L. HARRIS
Supervisor
Town Hall, 53095 Main Road
P.O. Box 1179
Southotd, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
Name of Applicant:
Mailing address:
Address of Property:
Ta× Map N't,~mber: lO00-
Prior owner if known:
GRANDFATHER APPLICATION
Tel No: I e 74qe/l' °'
10~ -lS--~ Approx. yr. of construct:
Diagram of existing structures, including all dimensions, must be
included with this application:
7. Indicate on attached map: Location. ie; reference point, telephone
pole nufaber, adjacent proper~~,~/etc. - ~>~ SOCG~ ~
ignature of applicant: ~~~ Date: ~~ ~%3 ~2__
' * Please no~e, there is a one time fee of $50.00 for filing this
application.
~'~E~I Y'.q~RK STATE DEPARTP%"!T OF F.r,vT~,~,,,.. .......
Regulatory Affairs Unit '-' ~',', ,~'~',h'.~L Cq~!SERVATIO~
Bu$1ding 40, SUNY
Stony Brook, NY 11794
Henry G. Ifilliams Commi s s ioner
. ,qO PER:lIT ;'!ECESSARY - TIDAL WETLA[!DS ACT //
/
A review has been made of your proposal to:
Loc~i oD:
Howevep, m~ additional woPk oP mod~¢'ica~ions ~o %he PPo~ec~ may PequiPe
a permit. It is you~ responsibility to notify this office in writinp if such
additional ~cork or modifications are contemplated.
Assuming you have obtained any other apmlicahle permits, you may proceed
with your project. - '
gJI.: R~'.!T: 11
Very truly yours,
Dani el.- O ,- bark-i n
Reginal Permit Administrator
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