HomeMy WebLinkAboutJurgens, George & EdithTOWN OF SOUTHOLD
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
SINGLE TRAILER OR HOUSECAR
LOCATION PERMIT
Date .. A~lt;l,],.....23,...1.9.7.0 .............................
Name G~or.g~..&..Edit~. Jurgens ........................................................................................
Street ..... ~ker s...Aa.-.&..M.~-dd.~e.--Rd .....................................................................................
Town .......~' OU.th 0.1~t..~...-..N, 'Y. w ....................................................................................................
Campsite
Your application for a (~Z~l~2~j~ permit was reviewed 'by the Town Board
on ................................. A~i~;[,1. ....... 2.~+ .......... , 19...~..O, and (]lgl~(was not) approved.
~.,?~e~n.x~__~__,_~__,_~., . ,, .de id . .
A
permit
is
hereby
i~J~l[~l,cense number .......... ~ .......
or serial number ........
...... 8hc~r.es.,...Gm,.e.z~por. tt..l~.~t.~ ............................................................................................
pursuant to application dated ..... F~Iy ....... ¶'~'"'1~'~O ....................................... and the followin~
e e~ e...o.~...zomi~.g., e~d.l.n,ne~.. 're~2ui. remen¢.s.. 'fora'.. 'l.i~i-nl~.. T~r ?o~e~i... use'-of
~'"%F~'tl'e'r..deni. e4-1..-..-F~-e...(.¢heek ).. $... ~.;.00.. re t~rne ~..h. erewTth ...................
TOWN BOARD, TOWN OF SOUTHOLD
Town ~Clerk
O
TOWN OF SOUTHOLD
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
April 21 Application No .....................................
Examined ................................... , 19 ..?..0. L..
Approved .................................... , 19 ........ Permit No .................
Disapproved a/c ...D..e..n.~e.d.... ................................................ ~ .........
Supervisor
APPLICATION FOR LOCATION OF SINGLE AUTOMOEILE TILAILER OR HOUSE CA~,
OUTSIDE OF TOURIST
· .u. arz.!, .
Date .....~...q]~.~. ............. . 19.?...0...
In~Tu~ion~
a. This application must be completely filled in by typewriter or in ink and ,submitted in duplicate to
the Town Clerk.
b. Plat 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 s hereby made to the Town Board for the issuance of 9 'l/railer Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffo k County, Ne~ York, and other appl cable Laws,
Ordinances or Regulations. The applicant agrees to comply with all applicable laws, ordinances and
regulations.
?
(Signature of appl~i~/_~'nt)
...................
O~ner
State whether applicant is owner, lessee or agent .............................................................................................
Name of Owner of prerrdses ....~}.eor. g~..R..&.]g~J-~h..T'-...Jgr..g.e/3~. .......................................................
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 ....W/~..~am. poA..D~..~,v.t~.> .......................
Street and number .GgO~....S/O..M4~&,n..~o~.....~'.ee~po~.t.s...N~.¥- ...........................................
2. State existing use and occupancy of premises and intended use and occupancy of proposed trailer:
a. Existing use and occupancy Utilit~ building.
b. Intended use and occupancy ...... Os~w?8-t.~,a ...................................................................................
c. Period of time trailer is to be located on premises ........................... ~e~er, en~,l~ ....................
dwelling is constructed.
until pel~manent (To be paicT on filing application)
Dimensions of trailer, length .............................. width .................................... height ..........................
Registration Number ............................................ Serial Number ............................................................
5. Size of lot: Front ....~,l~-.! ................................. Rear ..... 1~.2.!..., ................. Depth .....]J~,~.! ..............
6. Date of purchase or lease of lend ......... ~.~!.~....~,.g..~.~ .......................................................................
7. Zone or use district in which premises are situated. ..........~e,~ftc14)z~t.;[&l ...............................................
8, Does proposed use violate any zoning Iow, ordinance or regulation.;) ....................................................
9. o. Method of Sewerage disposal ....0h{~m~.~.8.~..TD.~.~,et~ .....................................................................
b. Source of Water Supply ............ ~e3..]..v ............ .... ..............................................................................
c. Source of Electricity ................ .~..o...~..e.....a...a.....o.~...~.e..~.e .....................................................................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimen-
sions from property lines. Give street and block numbers or description according to deed, and show street
names and indicate whe~er interior or corner lot. Indicate cle¢irly location of proposed trailer on prem-
ises, showing distances~ from all buildings and property lines.
Map of Southold Shores at
Arshamomaque, Town of Southold,
Suffolk County N.Y.
STATE OF NEW YORK I
COUNTY OF SUFFOLK~ss'
G..e~.~r~.e B.. Jurgen~
..................................................................................................... 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 duty authorized to make and file this application; and that all statements
contained in this application are true 1o the bestial his' knowledge and belief; and that the trailer will
be lOCated in the manner set forth in the opPlicatio~ filed herewith.
Sworn to before me this .............. ~. .................... day of ~
cs r ure)Fy
(Notary Public)
O
O
TOWN OF $OUTHOLD
TOWN iCLERK's OFFICE,
IOUTHOLD, N. Y.
Examined ..4~'~LL.;t,~ .................. , 19.7.(L..
Approved .................................... , 19 ........ Permit No .................
Disapproved a/c ..llllll~l~la ................................ ~ ............. : ..........
Supervisor
APPLICATION FOR LOCATION OF SING~LE AUTOMOBILE TRAILER OR HOUSE
OUTSIDE OF TOURIST CAMP.
Application No ..........................
Instructione
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, re at onshio to adjoin ne nrem ses or
public ~stree~ or areas, and g~wng a detailed description of layout of prop~ty ar~l prc~s~ed location
of trailer must be drawn on the diagram which is pert of this application.
c. Upon approval of this application, the Town'Board will issue a t~ailer permit to the applicant. Such
permit shall .be kept on the premises available for inspection.
d. NOin permit.trailer shall be occupied or used in whol~e or in part for ~,ony, ~rpose. whatever other than specified
Application is hereby ~nade to the Town Boa~ for the issu~r~Re of a Trailer Permit pursuant to the
Building Zone Ordinance of the Town of Southc~ld, Suffolk Count~, New York, and othe~ app cab · Laws,
Ordinances or Regulations. The applicant agrees to comply with all applicable lows, ordinances and
regulations.
~' '( 'iSig ature of opplicc~ ~ "'
State whether applicant s owner, essee or agert~' ./,~.e.z'~ ..
~ ,...? ~.~ ........ ~. ........................... ~ ......................................
.N, ame of .O~n. er of pre.mJses ..... ~41~Ke..B../~;~,.iLh..,.Z~/~.!.~TG~i~ ..................................
Ir applicant is corporate, signature of ~tuly aut~ rlzed off~ce~r
(Name and title of corporate officer)
1. Location of land. on which proposed trailer will I~;',l~ceted .... ~///'~,..~ll~l)o~..~&~l .......................
Street and...number "l~4t~l"'l~/O"llte~ It "Reel ~'i'"" ((~I~II~'~DI'41~ ~ '"!I~ '~v-r, [
2. State exi~hg' use and occupancy of premises c~d ietended "use and occupcmcy of proposed trailer:
a. EXi~t~hg use and occupency ...7..1~'.~.~.~q, RI,~ .............................................................
b. Intended use and occupancy ~ele ~.~& J ........
c. Period of time trailer is to be located on premises ........................................... .~ .......................
3. Fee ............................................ (To be paid on filing applicafiC~n)
4. Dimensions of trailer, length .............................. width .................................... height ..........................
Registration Number ............................................ Serial Number ............................................................
O
5. Size of lot: Front ..... 1,l~!. ................................ Rqar ..... 3.~! ...................... Depth ...... 3,,$.~.I. .............
6. Date of purchase or lease of land ............... ~. ....... I .................................................................................
7. Zone or use district in which premises ate situated...:: ....... l~el~1.d~zt~.,il~ ..............................................
8. Does proposed use violate any zoning law, ordinance or regulation.> ....................................................
9. a. Method of Sewerage disposal ..... ~.~.~..l$.~.g.a...~....T..q.[.~..~.~ ....................................................................
b. Source of Water Supply ............ .We~.~.o .............................................................................................
c. Source of Electricity ................. ....................................................................
PLOT DIAGRAM
Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate oil set-back dimen-
sions from property lines. Give street and block numbers or description according to deed, and show street
names end 'indicat~ whether interior or corner lot. Indicate clearly location of proposed trailer on prem-
ises, shOWing distances from all buildings and property lines.
Map of Southold Shores at
Arshamomaque, Town of Southold,
Suffolk County, N.Y.
STATE OF NEW YORK
COUNTY OF SUFFOLK
he is the upplicant named above. He is the ....................... ~.~[T~.~ ..................................................................
(owner or lessee or agent)
of said owner or owners, and is duly authorized to make and. file this application; and that oJI statements
contained in this application are true to the best of his knbwledge and belief; ~nd that the trailer will
be Iocc~ted in the manner set forth in the application filed herewith.
Sworn to before me this .................................... day of
........................................................ , 19 ................. ~ ..................
(Notary Public)