HomeMy WebLinkAboutAdler, Fred TOWN OF SOUTHOLD
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
SINGLE TRAILER OR HOUSECAR
LOCATION PERMIT
Date .. ~[arch...13... 1.c~6~ .........................
Town
Your application for o (single trailer) jll~l~ll~permit was reviewed by the ToWn Board
on ........................... ~.~'.~.~.....1~. ..................... , 19L6.8., and ~ (was not) approved,
A permit is hereby issued to locate o (single trailer)! (~j~i~lj~license number .............. .,..~ ........
or serial number ............... ~ ........................... at....:....]~'.t.'~/&t~...~Et~,..~.LGt~.8..,..~,~a~..
1~.~;)..~.~o1~ ,...~...~.. ................................... ~. .................................................. ~! ..................
pursuant to application doted ...F.~,~.ch.....0,...1.°~.68 ..................................... and the following
conditions: ...~..e...~..~...~..~... ~ ~..~..:l:.e..~...~... J... ~.~0~. !. ~hetl~lc.. [~l.~lJ-~el:l, .. ~ ~.~ .....................
TOWN BOARD, TOWN OF SOUTHOLD
Approved .................................... ,
TOWN OF SOUTHOLD
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
19 ........ Permit No .................
Application No .....................................
Disapproved ~jli~-....~ .........................................................
...................................................................................................
.................... :,...: ................... ,,~..,.-..:..: ...................... ;..
Supervisor
^Pr.~c^t,o. to..oc~t:o, oF s,.G.: ^u~oMoB,.: T~,.:. O..OUS: C^~
OU~S:D~ OF tOU.,St C~P.
Dote ..... ~./..'~. ..................... , ~9...~.~'
In~tn~tie~l
a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to
the Town Clerk.
b. Plot plan showing location of Jot and of buildings on premises, relationship to adjoining premises or
public streets or areas and giving a detailed description of layout of property and proposed location
of trailer must be drawn on the diagram which is par~ of this appl cat on.
c. Upon approval of this application, the Town Board will issue a trailer permit to the applicant. Such
permit shall be kept on the premises available for inspection.
d. No trailer shall be occupied or used in whole or in part for any purpose whatever other than specified
in permit.
Application is hereby made to the Town Board for the issuance of a Trailer Permit pursuant to the
Building Zone Ordinance of the Town of Southald, Suffolk County, New York, and other applicable Laws,
Ordinances or Regulations. The applicant agrees to comply with oil applicable laws, ordinances and
regulations. , .i.. ~::~,.., .~..~,?..~..,.~ .~.. ,~...: ........................................
(Signature~f applia~ant) ;
Store whether applicant is owner, lessee or agent ..... %..x~...-.':r~....~.;.~.: ................................................................
Nome of Owner of premises ...... ---~..:g..~...~.......~.~..~....~..."~' ................................................................................
If applicant is corporate, signature of duly authorized officer
(Name and title of corporate officer)
Location of land on which proposed trailer will,be located .....(~.'.£..'.~../~....~'.~.~.';..J.~...../~..X...~... ..................
Street and number ..~:..~ .......... ~...z ............................. : ........ : .................. , ................. ~ .......................
2. State existing use and occupancy of premises and intended use and ~cu~ncy of pr~osed trailer:
a. Existing use and ~cupancy ~'~ ~"
b. Intended use and ~cupancy ....~~-~...~...~ .............................................
t on rem,ses
3. Fee ....... ;7.~ .............................. (To be poid on fllin~ ~pplioati~)
4. Dimensions of trailer, length .~.~ .......... width ...... (~.:..:~ ........... height ....~... ~..
Registration Number ............................................ Serial Number ............................................................
5. Size of lot: Front ..... ../.~ ..O. ............................... Rear
" · ................................... Depth ...... ./..~. .................
6. Date of purchase or lease of land
7. Zone or use district in which prem ses are s tuoted
D ...............................
8. oes proposed use violate any zoning Iow ordinance or regu at on.;> ...../..4~.. ...........................................
9. o. Method of Sewerage disposal / C/
.~ ~.-.f ....................... :~. ..............
b. Source of Water Supply .... " ' '
c. Source of Electricity ~
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimen-
sions from property lines. Give street and block numbers or description according to deed, and show street
names and indicate whether interior or comer lot. Indicate clearly location of proposed trailer on prem-
ises, showing distances from all buildings and property lines.
...... .....
srA~ o~ N~w ~o~ ~ ~L~-6S
COUN~ OF SUFFOLK
............................................................ being duly sworn, deposes and says that
he is the applicant named above. He is ~e .~:~-~ >~
(owner or lessee or agent) .......
of said owner or owners, and is duly authorized to make and file this application; and that oil statements
contained in this application ore true to the best of his knowledge and belief; and that the trailer will
be Io~oted in the manner set forth in the application flied herewith.
Sworn to before me this ........................ /Z....~.~. day at
.......................... ;~.....~...'~r~. .... 19~.,~....
~___~. _ / ~ ..................... i~i~;;~i: ..............................
, · (Notary PubJ~)
TOWN OF SOUTHOLD
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Approved .................................... , 19 ........ Permit No .................
Disapproved JjiJrJ~.....~ .........................................................
Apl~lication NO .....................................
Supervisor
APPLICATION FOR LOCATION OF SINGLE AUTOMOBILE TRAILER OR HOUSE CAR,
OUTSIDE OF TOURIST CAMP.
Date ....'~../..~. ......................... , 19..~.~.'~.
Instructions
a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to
the Town Clerk.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or
public streets or areas, and giving a detailed description of layout of property and proposed location
of trailer must be drawn on the diagram which is part of this application.
c. Upon approval of this application, the Town Board will issue a trailer permit to the applicant. Such
permit shall be kept on the premises available for inspection.
d. No trailer shall be occupied or used in whole or in part for any purpose whatever other than specified
Jn permit.
Application is hereby made to the Town Board for the issuance of a Trailer Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,
Ordinances or Regulations. The applicant agrees to comply with oil applicable laws, ordinances and
regulations.
(Signaturf~ of al~plicant) ·
......................................... f ...... ..........
State whether applicant is owner, lessee or agent .....~.~ ......... ~...'~.....' .................................................................
Name of Owner of premises ..... .~.-~..~.~.i.~........~..~.~..~....~...' ...................................................................................
If applicant is corporate, signature of duly authorized officer
(Name end title of corporate officer)
1. L~at on of land on ~hich proposed tr~.iler will be ,l~ated ...n..:..+~ ........ ~. ..................................
Street and number ..... ~.~.;~.~... E~.. :~..:..~.~'~ ;~ .~..~ ...~..~ .........................
2. State existing use and occupancy of premises and intended use and ~cu~ncy of pr~osed trailer:
a. Existing use and ~cupancy ...'~.~...~.~f~....f~.;~....~; .........................................
b. I ntended use and occupancy ...~.~}.bz}(~....~}:....~ ...........................................................
c. ~riod of time trailer is to be located on premises
3. Fee ....~..' .................................... (To be paid on filing appticati~)
~0 t~ .................................../at '~' height
.' ....... ........ w,,t
Registration Number ............................................ Serial Number ............................................................
5. Size of lot: Front ....~..~-?. ................................. Rear
.................................... ~,pth ...... /..~.:~i ...........
Da,e of p.rchase or 'ease of
7, Z~e or use district in which premises ore s~tu~ed..~.,.,~.~ ....
8, Does pr~osed use violate any zoning law, ordinonce or regulation? ...~..; ........................................
9. a Meth~ of Sewerane sn '~ ~'~/~ ~
, ~ d ~osal .............. .~. ................................................. ~....?. .........................
b. Source of ~ter Supply .....................................................................................................................
c. ~urco of [lectrici~ ......... ................................................................................................................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate a. II set-back dimen-
sions from property lines. Give street and block numbers or description according to deed, and show street
names and indicate whether interior or corner lot. Indicc~e clearly Iocatio~ of proposed trailer on prem-
ises, showing distances from all buildings and property IJnes.
........
STATE OF NEW YORK
COUNTY OF SUFFOLK/ss'
....E/LE.~......4. .O..4.~../~ ................................................................. be,rig du~y sworn, d,~ase, ond soys that
he is the applicant named above. He is th~ (~,- .-~'-,-'t...~% .
(owner or lessee or agent)
of said owner or owners, and is duly authorized to make and file this application; and that all statements
contained Jn this application are true to the best of his knowledge and belief; and that the trailer will
be located in the manner set forth in the application filed herewith.
Sworn to before me this .......................... ./.4".:.. day of