HomeMy WebLinkAboutBolling, WaddieNo. !~
TOWN OF SOUTHOLD~
TOWN CLERK'S OFFICE
SOUTHOLD, No Y;
SINGLE TRAILER OR HOUSEC ~R
LOCATION ~ERMIT
Date
Name . M~dd~,, ~ll~n~ ..
Street ]~ 1~_ _~4 .
Your application for a (single trailer) (~ permit was reviewed
by the Town Board on .D~Ig..~, and (was) (~approved.
permit is hereby issued to locate a (single trailer) ~ license
number
or serial number
and the following
pursuant to application dated ru~,,,,~__~ _~; ~_~_ .
TO%V~ BO-~RD, TOWN OF SOUTHOLD
....
Inztructions
m. This ~%~$ti~n ~.s~--b~ cb~letely 'filled in ~y t~e~iter er In ~ ~ ~-
b. Plot pl~ s~wing.lcca$ion c~ lot sn~ off .~d$~.9n pre~iaes, ~e.lat$cn~i~ te
.... ~o~n{~g oremises or public str~e~a-,c~,~as,· ~d g~i~ a detailed dezcriptiOa
~. ~,ef.
ever othe~:~ '~ecifie~
lTew York, ~ ot2er applicab~.e
If aD~lic~$, iea cc~c~te. ~i~ature of d~y authorized officer.
(Name and ~it~ of co~orate of~cer) -' '
1. Location eft l~ on ~ich ~ro~osed tr~il~will be ... ,.,.,,.,,,.,.... .... ,
2. ~tat'e exi~$i~
proposed ~raile~
b. Intended u e an ' c ..,....,.,,,.... .....
c. Perio~
~ · ~ .~.~ ~ ~ · , ,
5.Size of lot1 ~ont .....
7. ,Zone or.u~e diztrtct in which pr~mises are sit~t~d,.,...,..~..~,, ........
~ .
c. S~d~ o~ el~c~riel~y. · . . · ............................
- u~e by thw -Mother In :~w of ~e ~ ~ o~er. .....
~ere or de~cr'ioti~n ~cc~r&i~ to '~ei[ amd Chow s~$re~' ~a ~ [i~te wh~th'er
~n~r~r'o~'cor~r.lct, ,$~icate cl6arly loeation
/....~,~ ~i:~ ~
.. .., , - .~ ~.~.. . .~,.
·.~-ff:~../ .. · ........
Ommty of ~ff~k
.... .(o~er cr losses,er ~ent)
cf ~aid awnar or o~ers-,~d is duly ~thorized t~mskc ~d ~lC this a~l~gatlon~
~owledge ~d belIe~; '~$,.$~a~ tho. ~rat~e~ ~ll be located xm the ~*~cr se~ forth
Swo~to ~efiro ~e ~hts ~ ~ of
....
(NotaryPubl[c)
· - ( Supervisor
APPLICATI01~ FCtt L~CATION OF SII~GLE AUTOHSBIL5 T~ILER aR HOUSE C~, )~SIDE ]F
TO~I ST C;~
- - . ~ate .......... · , · -
'' I~st.mat i.o~
a. Thio application mus~ be c~i~tely filled in by t~writer '6~ in i~ and
mitred in dur~licate zo the Town Clerk ......
b. ~lot ~l~ showin~ location of lot end of %uildi~s on Tremis~z, relatlcnshiF
a~joining rremises or public streets or areas, and givl~ a detailed description
of layou~ of yroper~y and proposed location of trailer ~st bs ~rawn cn the
di~ram which is par~ of this application.
c. ~on approval of this application the .Town Board will issue a trailer p~rmit
to the applicant. ~ch permit shall be kept on the Frem~se~ available for
spection.
d. 17o trailer shall be occurled or used. in whole or in part for any p~o~e what-
ever ether th.~n ~pecifiod in rermit.
Application is hereby made to the Town Board for the issuance of a Trailer i~ermit
_rursuant to the t~uilding Zone Ordinance of the Town oF Sou%hold. Suffolk County.
i~ev York, and other aprlica%le Laws, Ordinances or Ke~lattons. The applic~t
agrees to comply with all aEplicable lawc, ordinances ,~d re~lations.
(Sir:nature of ~r~tcant)
Aidress
State whether applicant is owner, lessee or
If applicant is a co.crate, si~ature off.duly authorized officer. '
(Nome ~nd title of co.crate offficer)~
1, Location of lan~ on which ~roposed trailer will be
2, ~Stat~ existi~ use sn~ occu~ancy
proposed trailer:
b. Intended use sn4 occurancy ,}$. ~. ~.M9~1$. . , .... ' ................
c. Period ef time trailer t~ te be located on premises .'~$~$.., ......
Dimensions of trailer, long~h;~lwidth~', ~t$~elght,~X;~l~d ....
Regimtr~tion ~ber ...........................
5~', Si~c cf lot~ ~ont..~.~B~..Rear,~..~e~th/~e~.~
6'/"~to'of ~oh~.~ o~ ~o~ of ~..~...~/,'..'~A~'A.'.~.~.~'.~'.r..
7. Zone or u~e district in whlch,~p~.e,~ ~. ~P~,~L'' ''~.'.'~.','~ ..........
9. a. Methb~ 'o'f ~'eW~e di =peru,' ~'~ ~$~1~ .~ ~Z. 9.% ........................
%. Source~ of Wrater
c. Source of elootricity.~aIg.~X$~$~.O$, ..... ~ ......................
8~Mi~J~ lfobtXe Homo will be !ooa~e4 ,in ~ho ~ of b bre now in
m b2 ~ho Ifo~her ln~.~e ifob~Ae ~ owuoz-.
-'Locate clegrly a~=d distinctly ~tl ,buildings, whether 2ximti~ o~ pxopesod.
indico,tc a&l s~t.-back dimensions from proEoert~ line~.. Give s~neet
'~ors or dt,~criution accoriing re deeik o.nd show stree~ no~mes ~d indicate ,,fhcther
tn~erior or corner lotJ 'Indicate cloo. rly loca,tion.of proposed tra~leE.on
ehow~g dict~c~ ~m~lgs '~ ~rppcr~y lines,
County of Suffolk ....
I~b ~' .¢.~,,"- '~' ~ ..,,.,bein~ duly sworn, dolooses ~nd says tho,t
ho is %he ~pplic~nt above homed. Ho is tSo'~[i..........,.........i'...:'...~ .... ~
(owner or lessee,or o~ent)
of ~sid, owD9r, or. oyners, ~nd is duly ~uthorlzed to ~ke ~t file this atplication;
and th~ ~li,~.~,~o~$~>~ cont~Aned in this applic~.tion o. re t~e ~o thc best of his
knowlo~%o ~nd belief; c,nd'%~,% %ho t~4l%cr'~ll'b& loch%oR in tho ~,nncr set forth
in thc o~pptl~%~ ~on filoi therewith.
Sworn ~o ~qforc me thi~ ~'~' d~.y of
....~...~..,.;.-.. ..... ~%..~..., .~ ~ ~,d,~ ~,~-~ ~
. ~L4~. ~.-;.-.-~. :~. ~ . 6~ .....