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HomeMy WebLinkAboutCarlin, Frank TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. SINGLE TRAILER OR HOUSECAR LOCATION PERMIT Name ~. ~.~1;:1~...(~i~.l~ ................................................................................................................ Street .... !:~..1..~....i~.q~ .~. ..................................................................................................................... Town ....~.¢~ ~...J~.*.~* .............................................................................................................. Your application for a (single trailer) ~ permit was reviewed by the Town Board on ................................. 7~.....~g ................. , 19~..., and ~}. (was not) approved. denied A permit is hereby~ to locate a (single trailer) ~), license number ........................ or serial number ................................................ at ...................................................................... ... ~..~ ~.~..~ ~.~ ,...~.~.~ ~.,... ~,. ~.~.~. ..................................................................................... pursuant to application dat~ ....... ~[a~-.J.3.-...~.9~ ....................................... and the followine conditions: . ~.~ ~.~ ~.~... ~.~.l~ ~.. ~...~.~...~ ~.. ~..~ ~ ~.. ~.~.~.~ff.~.. ~ [~.! ~ .............. TOWN BOARD, TOWN OF SOUTHOLD TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N.Y. Approved ...................................., 19 ........Permit No ................. Supervisor APPLICATION FOR LOCATION OF SINGLE AUTOMOBILE TRAILER OR HOUSE CAR, OUTSIDE OF TOURIST CAMP. Date ....;::.~"~.¢?..:..i .............. , 19...~..~..: Instructions This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Town Clerk. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving ~ detailed description of layout of property and proposed location of trailer must be drawn on the diagram which is part of this application. Upon approval of this application, the Town Board will issue o trailer permit to the applicant. Such permit shall be kept on the premises available for inspection. No trailer shall be occupied or used in whole or in port 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 comply with all applicable laws, ordinances and regulations. (Signature of applicant) (Address) State whether applicant is owner, lessee or agent .............................. ~ .......................................................... Name of Owner of premises ~z /~/~/~ ~'.~?[~.~-~.~ ............ 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 ........ ..~.T.../'.~.(..?'.~..~.~..../m.. ......................... Street and number .......... ./.~././..~.../../...~.......,'~..~..C~..~..-./~... ....................................................................... State existing use and occupancy of premises and intended use and occupancy of proposed trailer: o. Existing use and occupancy ................ ./~..~?.;..c~:..~. ....................................................................... b. Intended use and occupancy ,,/~i/~//y~<~ ~'~..,/?/Z' /--.~z__'-/zZ _~ c. Period of time trailer is to be located on premises ........ . ............................................................. 3. Fee ............................................(To be paid on filing application) 4. Dimensions of trailer, length ............................ width ................................height ............................ Registration Number ......................................... Serial Number ............................................................ 5. Size of lot: Front ....... ../.'.~'~! ...... :~'.~.~ ........ Rear ........ ;./..~.t~...~.~.~.:..~.. Depth 6. Date of purchase or lease of land ....... ¢:~..'~..;:~.~.. ................................................................................ 7. Zone or use district in which premises are situated ........................................................................ 8. Does proposed use violate any zoning law, ordinance or regulation? ....... ../~..:~.c..~ .................................. 9. a. Method of Sewerage disposal ......... .C.~..z.~.~:.6.1./'~.f~.~z ................................................................... b. Source of Water Supply ........ ./..~(f.:.f.'...~...(.~..,..~.f.~.~-~..~ .......................................................... 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 corner lot. indicate clearly location of proposed trailer on prem- ises, showing distances from all buildings and property lines. STATE OF NEW YORK ~NTOINk'T'rE liERKO~KI I~IOTARY PUBLIC, State of New York Residing in Suffolk Ceunty COUNTY OF SUFFOLK ss. No. 52-450079R ~.-} , ~ommisslon Expires Mar .............. ?-;.,:'~.~.'~...~-..r~.?..~...~;.~.~.Z~,~/.~r .................................................. 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 moke 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. Sworn to before me this ............. :...: .............. day of ~.~./..fi~.~.'::?./.~..-~..~.~..~'. ........................ , 19 ,//.Z~ , '---- .... .~,.r~..~'z- ~, .~-~ ~ '/. ',, · (Signature) ........ ..................................................... (Notary Public) TOWN TOWN SOUTHOLD, N. Y. Examined ............. ~...~.//.:.:...~/~......., 19.Z.~' Approved .................................... , 19 ........ Permit No ................. D,sapproved a,c ...... ............ ......... OF SOUTHOLD CLERK'S OFFICE Alzplication No ..................................... ~uperwsor / APPLICATION FOR L'OCATION 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 locution of lot and of buildings on premises, relutionship to udjoining 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 diagrum which is part of this application. c. Upon approval of this application, the Town Board will issue a truiler permit to the applicant. Such permit shall be kept on the premises avuilable for inspection. d. No trailer shall be occupied or used in whole or in part for any purpose whutever other than specified in permit. Application is hereby made to the Town Board for the issuance of a Trailer Permit pursuunt to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Luws, Ordinances or Regulutions. The applicant ugrees to comply with all applicable laws, ordinances and regulations. o (Signuture of applicant) (Address) State whether applicant is owner, lessee or agent .................................... ~ ................................................. Name of Owner of premises ..... ~..~.'.':.'.4./.,ZC.~.~ ....... ..~.~.~T~...7.~.'...~.../.'.~ ........................................................ 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 ....... ~../~..J~...~.....~.~...~.. .............................. Street and number ...... <?...7./.~...4~..~......~.f?..(~....~.. ................................................................................ 2. State existing use and occupancy of premises and intended use and occupancy of proposed trailer: a. Existing use and occupancy ........... ~....~.,t*~..~ ............................................................................... b. Intended use and occupancy /_L/J /x/(_~ C, c /~/- / ~--AZ _~ c. Period a{ time trailer is to be located on premises .................. ~ .................................................. 3. Fee .... :.....i;~.: ......................... .... (To be 'p~id on filing application) 4. Dimensions of trailer, length ............................ width ................................ height ............................ Registration Number ......................................... Serial Number ............................................................ 5. Size of lot: Front .......... ./.../...O...../.~....7~.. .......... Rear ......... ./....~..~ ........... Depth ...:~..Z..3..~..-....~.~.~..6'~' 6. Date of purchase or lease of land ........... ./...~..~.i~.~.. .......................................................................... 7. Zone or use district in which premises are situated ........................................................................ 8. Does proposed use violate any zoning law, ordinance or regulation? ........... .~.../...~.. ............................. 9. a. Method of Sewerage disposal ............... .d.'...~.(~..~.,~'.~'..~'....~. ............................................................. b. Source of Water Supply ................. :~..~:~..~.'..:~..~,~'. ....... ~.?./.;~...z:...~ .................................................... c. Source of Electricity ........................... ..~.,./.:..~,.,..~.....(.~: ..................................................................... PLOT DIAGEAM 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 corner lot. indicate clearly location of proposed trailer on prem- ises, showing distances from all buildings and property lines. ~ ANTOINEI'rE BERKOSKI STATE '~ , NOTARY pUBLIC, Sta~e Ofcounty~eW York OF NEW Y~EK ~ ~esid n~ in Sufiolk ~ COUNTY OF SUFFOLK-ss. ~. 52.~50079~ ,,,- . ~ / ~ ~ . ~. CommissTon Expires Mar, I: ~(), ~3 ~ ........ : ....... ;..:;..<.'.~: .......... ~.~.~?:..~. .................................................. being duly sworn, deposes and says that he is the applicant named above. He is the ......... ~:.~:..:,.¢,X.,;.....; ................................................................ (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. Sworn to before me this ................................ day, of · ....... .................................. , .................. (Signature) .... ................. (Notary Public)