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HomeMy WebLinkAboutBailey, PatriciaTOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......-.~...'~-./.~....~.. ............. , 19...~...7 AFplicaHon No .................................... Approved .................................... , 19 ....... Permit i'qo ................. Disapproved a/c ........ ~_ r.M._..~_/...~ ........................................ APPLICATION FOR LOCATION OF SINGLE AUTOMOBILE TRAILER OR HOUSE CAR, OUTSIDE OF TOURIST CAMP. Date 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 o~ 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 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 Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations. The applicant agrees to comp!y_~with all applicable laws, ordinances and regulations. State whether applicant is ownez,_lessee or agent ...................... ~....~?i~....(......~ ...................................... Name of Owner of prom,sos ..~...`x.~..c7~.~.[..~...~k~:.~...~.~.K~.J:.~...~......~.d...-~..~.~..w1 ............................... If applicant is corporate, signature of duly authorized officer ~ of land on which proposed trailer will be located ...~.~..~,:..~/~:~.~f<.,~J...dd..~O..~,~ 1. Location Street and number ...................................................................//l//l~-.~....~..~..~.~.¥~..:~d,~,..,~..i.?...,.-'~l,~- ...... 2. State existing use and occupancy of premises and. intended, use and occupancy of proposed trailer; c. Period of time trailer is to be loc?ed :on premiss r ...... (J~,~ ..... ~:~,~.....-~-~-~.-~ 3. Fee ............. ~..~..~...~ ............... (To be' pai~ on filing application) 4. Dimensions of trailer, length ..;.D....:.. ............... width -- height ........................... Registration Number ......................................... Serial Number ...... v'"";'""; ...................... ~ ................ 5. Size of lot: Fro~n~ ......... ~_........Z;......('~:.,.%,:__'2_: ......... Rear ................................ Depth ................................ 6. Date of purchase or lease of land ~"/~'-~- .~.. 7. Zone or use district in which premises are situated ............ ~.Z,.~ ~ .~. ;:.~.. .... 8. Does proposed use violate any zoning law, ordinance or regulation? ....¢~.~.~..~...~ .................................. Method of Seweraae d sDosa ..,~..¢, ................... ,, ....... 7 ....... ""~' ................................................... n/? Source of Water Supply .............. ,.....: ............................. J,c.L.-~.~..'~... ........................................... Source of E ectrcty .;.~..-~.'2'..:.~. ..................................................................................... PLOT DIAGRAM Locate clearly and distinctly all b_uildings whether existing or proposed, and nd cate a set-back dimen- sions from property Ikhes. Give str~'et and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. Indicate clearly location of proposed trailer on prem- ises, showing distances from all buildings and property lines. STATE OF NEW YORK } COUNTY OF SUFFOLKjss' ............ ~,,4.~¢.~, ...... ~....Z4../... ~ .................................... being duly sworn, deposes and says that ~,%he is the applicant named above. He is the /L_ ~:~ ,~z-~ (owner or lessee or agent) of said owner or owners, and is duly authorized to make and file this application; and that ell statements contained in 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. .............. .......... L (Not~/Public) / MURIEL BRUSH NOTARY PUBLIC, Sfa['e of New Y~rl( No. 52-4522026 - Sui%ik Oounfy Comm[sslon Expires March TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUT,OLD, N. Y. Examined ......... ...O~..../...3~...~'... ......... , 19...? .Z. Approved ........... ~ ......... , l~Pem-~it No ................. _/ / Disapproved a/c .... ...,~../....2~...~....../....~....~. ....................................... Applicction No .................................... Supervisor APPLICATION FOR LOCATION OF SINGLE AUTOMOBILE TRAILER OR HOUSE CAR, OUTSIDE OF TOURIST CAMP. D te ...... ...... , 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 wi~ich 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 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 Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations. The applicant agrees to comply ,Ivith all applicable ,laws,,~rdinances and regulations. ~'~z--'Z~, ''' State whether applicant is owner, lessee or agent ............ ~,..kk~..l.~.~..~ ....................................................... . . Name of ~ner of premises .......... ~.~..~K,..~..~....~.~L.L....~..~,..J.~..~+ ............................................. If applicant is ,.corporate, signature of duly authorized officer (Name and title of corporate officer) ' 1. Location of land on which proposed trailer will be located .~.~;/~,~,~.;~.~,.~..:....~. ............ Street and number ......................................................................... ..~.~,.,.~./...,.i:~...~.~ ...... 2. State existing use and ~cupancy of premises and intended use and occupancy of proposed trailer: b. c. PeriOd time troller is to be ~coted on premiss .... z.),~.C.~.--,~.,..:,~:..: .................. 3. Fee ...... ....:~...L..~..~ ................. (To be paid on f ng app cat.on) 4. Dimensions o{ troller, length ......... :...5: ............ width ........ /;.,:~I ................. height ....................... Registration Number .Serial Number 6. 7. 8. 9. Size of lot: Front .. ...~. ~: ..................................................................... Zone or use district in which ~ ~ Does proposed use. violat~e_,~.9~_, zoning law, ordinance or regulation? .......... }~.~. ................................ b. Source of Water Su~p%~/~'~:.~,~L-- ~1~ c. Source of Electricity ............... ::,~::L~?.Q,.~. .................................................................................. PLG? DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed and indicate oil set-back dimen- sions fro~, property lines. Give street and block numbers or description according to deed and show street names ar)'d indicate whether interior ar corner lot. Indicate clearly location of proposed trailer on prem- ises, sho/Wing/ distances from all buildings and property lines. STATE OF NEW YORK 'J COUNTY OF SUFFOLKjss' ............... · /.i.~/~..,~...::~.z;.,(f ....... ~..~'~.,-<../.~.~:-)' : .......................... being duly sworn, deposes and says that he is the applicant named above. He is the (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 in 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. ~ff' / . _~ L,/ (Signature~~ ............ ....... (Nota~ Public) NOTARY PUgLrC, State of New York No. 52-4522026 - 5=ffo[k County Commission Expires March 30, 19,..~