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HomeMy WebLinkAboutHorn, HeleneTOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined July 30 ........ .................................... , 19 68 Application No ..................................... Approved .................................... , 19 ........ Permit No ................. JJ~eplJ.'e,,,~4c~ ~ni~ .............................................................. APPLIGATION FOR LOCATION 01: 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 end 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 o 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 comply with all applicable laws, ordinances and regulations. (Signature of applicant) (Address) State whether applicant is owner, lessee or agent .......... ~ ............................................................ iNf amelof Owner of premises ....~.~....~......~....~.....~...,.~ Iapp icant is corporate, signature of duly authorized officer (Name and title of corporate officer) ~ ~.~.~ ,/ 1. Location of land on which proposed tra,iler will be located ~.J...,,-~IL...~..-~,~....~....r..~..~ .... Street and number ~.....~.....~...~.. ................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed trailer: b. Intended use ond occuponcy 3. Fee ............................................ (To be paid on filing applicafion) 4. Dimension~e~'gth ........ ~...~) ............... width ......... '...~. ................... height Registration Number ............................................ Serial Number ............................................................ TOWN OF SOUTHOLD TOWN CLERK'S OFFICE Exc~nined July 30 ........ .................................... , 19 68 SOUTHOLD, N. Y. Application No ..................................... Approved .................................... , 19 ........ Permit No ................. ~ ~enie~ .............................................................. · APPLICATION FOR LOCATION OF SINGLE AUTOMOBILE TRAILER OR HOUSE CAR, OUTSIDE OF TOURIST CAMP. ......... Instructions a. This application must be completely filled ia 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 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, ordincmces and regulations. (Signature of applicant) (Address) State whether applicant is owner, lessee or agent .......... ~ ............................................................ Name of Owner of premises ....~.~....~......~....~.....~...,.~ ...... If applicant is corporate, signature of duty authorized officer (Name and title of corporate officer) ~ 1. Location of land on which proposed trailer will be located ..... ~ ......... ... Street and number ~.....~...~..~,, ............................................... 2. State existing use and occupancy of premises and intended use and occupancy of propose, d trailer: 3. Fee ............................................ ~,~o De paid on filing application) 4. Dimension th ........ ~..~) ............... width ............................. height .......................... Registration Number ............................................ Serial Number ............................................................ Size of lot: Front ..... /...~....G....~. ................. Reer ~,3..~...~... ................ Depth~..7...~...-;..~.. ........ Date of purchase or lease of land .......... .'~J~.......:.~....~....~.....~..].../...~....~...~ ........ Zone or use district in which premises are situated ..................................................................................... Does proposed use violate any zoning law, ordinance or regulation? ...~<f,~.....~ ............................... Method of Sewerage disposal ........ .~....?-:.....~..~ ........ ~.....o....o....~. ............................................................ Source of Water Supply ....... ..~...¥A.L~i~:~ ......................................... i....: .................................... ~ ...... Source of Electricity ......... ...~. ~..~....~..0 ................................................................................... '~' . ' ' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oll 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 pFoperty lines. /. STATE OF NEW YORK i COUNTY OF SUFFOLK[ ss. .....~.~......~... ........ ..~..~ ............. 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 oll 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 t~ before me this ....... ..~......~::..; .................. day ........... .......................... ,, .... ................... / ~ ~ ~ (Signature) ~TARY ~LIC, State of New YO~ ~- 5~-~33120 ~uffolk Tern ~es ~rch 30, O TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......,~...1.~...3~.. .................. , 19 ...6~,.... Application No ..................................... Approved .................................... , 19 ........ Permit No ................. APPLICATION FOR LOCATION OF SINGLE AUTOMOBILE TRAILER OR HOUSE CAR, OUTSIDE OF TOURIST CAMP. Date .~....k~....!.~. .......... .~......, 19.~...~ Instructions a. This application must be completely filled in by b/pewriter 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 jn 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 comply with all applicable laws, ordinc~ces and regulations. ................. (Signature of opplicm~t) (Address) State whether applicant is owner, lessee or agent ......... ;(~,~,:~.~. ............................................................ Name of Owner of premises...~2.,~,..?..~.. · · .c~. ·.....?.~.....~.,....~.. ~ .............. If applicant is corporate, signature 6'f duly authorized officer (Name and title of corporate officer) ~,~ 1. Location of land on which proposed trailer will be located -e~/ ' . Al ~ / . / ~ ~,~ _~ Street and number ~.....~....~..~... ...................................................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed trailer: a. Existing use and occupancy ..~...~.~~r.~.~.~./~/-~, b. Intended use and occupancy ...~~.~C~......~....~...~~,~...n. c. Period of time trailer is to be located on premises .~...d...~.~/-~.C,~.,.~....~.,~,~,~,~-~,~ 3. Fee ............................................ (To be paid on filing applicatian) a ~ ~- · 4. Dimenslon~h ........ ~.~ ............... width ............. ~ .................... height .......................... Registration Number ............................................ Serial Number ............................................................ Date of purchase or lease of land ........... 1...41,I,I,I,I,I,I,I,~ ....... ...~....~..~....~..~../...~...~..,~ .......... Zone at use district in which premises are situated ..................................................................................... Does proposed use violate an)/ zoning law, ordinance or regulation? .....¢'z,,,r,~ ..................................... C ~ a. Method of Sewerage disposal ................. .T~..~ ........ ~....p...¢~..~, ............................................................ b. Source of Water Supply ........ .~...,,,/..J~.p .......................................................................................... c. Source of Electricity ............~..~....~....~..(D ................................................................................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oll 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. STATE OF NEW YORK COUNTY OF SUFFOLK~ss' ........ · .~...~----~= ............. being duly sworn, deposes and says that he is the applicant named above. He Js 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. Swo~-~ before me this ......... ...~.......~... .............. dayof ......... ............................ , ....... ............... ~ /// ~ ~ ~-~,-'~') (Signature) (Notary Public) ~ (/'/ MARION A. REGENT NOTARY PUBLIC, State of New Yort~ No. 52-3233120 Suffolk County Term Expires March 30,