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HomeMy WebLinkAboutTR-31-13-3 GFBoard Of $outhOld 'Town Trustees SOUTHOLD, NEW YORK PERMIT NO..31-z.1.3-3 ..... DATE: ..!.-_28-93 ........ ISSUED TO ........................ ff. ohn ...... .~.illi~m.~ ........................................................... Au 'horiza io. 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 Resolution of The Board adopted at a meeting held on 19 9.3., and in consideration of the sum of $...e×empt 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: Grandfather permit to replace bulkt~ead damaged from storm. all in accordance with the de+ailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees h,ere- by causes its Corporate Seal t' be subscribed by a majority o~ be affixed, and these presents to ~.~dBoard as~fthisdat~e. 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 SCOTr L. HARRIS Supervisor Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765- 1800 GRANDFATHER APPLICATION Name of Applicant: Mailing address: Tel. No: Tax Map Number: 1000- O3/-/3 -5 Approx.yr.of construct: /?~O Prio~ owner if known: .~0~6/ ~ f/~ ~c~/cc~ 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//: _- _ - Date: , Please note, there is a~one time fee of $50.00 for filing this application.