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Home My WebLink AboutPust, Valentie J. & Erika J. TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. SINGLE TRAILER OR HOUSECAR LOCATION PERMIT No ..... .t 1.", .......... Date ....... NJa.y...:l.~l ~... 1 ~ I] 7. ................................... Name ......... .U.~. ! e..n..t, i .n...e....J. :....&.... ,E.r.i' .k..a....J..~....P..u...s.~ .......................................................................... Street ...........].SJ] 7..,$.y. ca mQr. e..A~er~ue ........................................................................................ Town ........... .N. 9..r.~:~l..~,?.L~.~'.i~ J$,... J~ ,..Y. ...... :1. ].5.1~ ~. ............................................................................ ¥ou~: application for a (single trailer) ~[~1() permit was reviewed by the Town Board on .......................... .NJ..a.y......1..~l ............................ 19.J]7...., and (was) ~x:~l~t) approved. A permit is hereby issued to locate a (single trailer) ::/l:bl~:~clil~, license number ........................ or serial number ........... r.~.r.r.r, rrrr..rr..r.r ........... at .n~r. th..sid~..D.f..Middle..Road ................. ...5.0.0...f.t,,...~a ~...o.f..N]]ll..~ciad.,..P. ecanic,...N,.Y. ....................................................................... pursuant to application dated ................... ~i].y...~,...l~l[JT. ................................. and the following conditions: ......... .P..E...R.~.I..T....G..R.A...N...T..E...D.....F.Q.LR. _A....!.W...O....(.:LL .~.O...N..T..H....p...E..R....O. ~ ..O..N...L...Y... ........ ............................ [~..X ..P.!..R. A .T.I.Q.~....D./~I.I~ .~ .... J..U~..Y...:~.b...:l.~.l] 7. ..................................................... TOWN BOARD, TOWN OF SOUTHOLD p~CEIVED MAY 6 1987 Southold Town Clerk TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ..................................... Approved ................ ~Z.~......, 19~/~...Permit No ................. APPLICATION FOR I.:OGATION OF SINGLE AUTOMOBILE TRAILER OR HOUSE CAR, OUTSIDE OF TOURIST CAMP. Date ..... ~'~......~'. .......... , 19..~/~..... Instructions o. 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 c~ 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_c~o~ply with all applicable b:~m~-~ordinances and ....'~.. ~A;' .~.~.......~./.~,~'~A'T. ,,~7,.. ~?_/~,~/('/.~(Address)/~- . . State whether applicant ~s owner, lessee or agent ....... ~. ........................... ~..~ ................................... Name o~ ~ner of premises ..... .~/~..~.~....,.~..~....~.~...~ ........................... If applicant is corporate, signature of duly authorized officer (Name and title of corporate officer) Street ond number .~.. ~ .................................................. 2. Store existino use ond occuponcy of premises ~nd intended uso ond ~cuponcy of proposed trailer: ~ . m · / . b. Intended use ~nd occupancy .~~..~.~~..~....~~&~ c. Period of time trailer is to be I~ated on premises 4. Dimensions of trailer, length .~.~..~.....width ..... Z~.T~." ........... height ..... Z..T~.~.t.. ....... Registration Number .~.~[~ ................... ~ Seriol ~umber ....~...~.~..~.~~ 6. 7. 8. 9. Size of lot: Front .............~..~.~.. ..................... Rear ........ .-~..~..~. .............. Depth ......... '.~.../..~.. ............. · ~,~ .~. ....~.. ..... ~ ?" ~ ~ ~ ~ ,: Date of purchase or lease of land ....... ~"~/~.:... ./..~.~.~.. /f~.~.~'. ...................... Zone or use district in which premises are situated .... ~.~...~.~'/.~/..../~.~.,~J.~ ................................... ~. Does proposed use violate any zoning law, ordinance or regulation? .................................................. a. Method of Sewerage disposal ..... ...~..~./.?...7'../.~.'~...~......./~....'~....~...~...)(...~...~.....~.'~Z/.~ ............................ b. Source of Water Supply ........ ~.z'~./.~...~-/..'~..~....~-~'.~..*'~',~.,~.~'T~......~'..~..'....L,. ....................................... c. Source of Electricity .... ~/~,¢~./t(.~'.~.~./~ .~.....ZT'.~:?...,~.'~.//~s'~....~..Z'~..Z~'.~['~ ....................................... 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 '1, _ c [:r TX oF SUFFekK ..Cd. ....................... ~....~,z..-~....~.z .................................................... 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. Sworn to before me this ....~...~. ................day of~'~ ': ~ '~-" 19 ~ ........................... ~'~'na'~[J;ei .................................. ..... ..................................... . ............ ......... ............................... ~(Notary/Public) Nota~/Pub#e, Stmte ~ No. 4822563, Suffolk Coumy .~ Y' Term Explre~ December 31, 1~ /J ~' : : * '1 ............ ~ ~ ' ~ ~ ~ ~ATEMENT OF NTENT ' ____.....,.... .... .. ' ..... 4 wA~E~S~Y AND SEWAGE DIS~SAL _ '~'- I -~ A~ ~ ~~ ~E~ FOR THIS RESIDENCE WILl ~ '~ / r : p~IC. ' '~ SUFFO~.: . CO. DEPT. OF HEALTH sERVICES. ~.v,~.-.o. ....ov.~ o~ A~ROVED: DIST. %CT. BLOCK PCL. · .: .... , ..... ,'~,~ ~ AVE. ~ '~i4&--~- ' ~-' ~ z~ 2=-~ . '51LTY J ~ .... -;-' ..... I **~. ~. ) /_~ ¢r.~ ~.,_., ,~-,-- 40'¢.~ __CO:"3 V~5_.... ...... C-E? ['~ ............... TO. ~'~ ¢~A L&'TE L. :. W~. _~ z:g ~: '-,. '.'.'7' J ' ' ':": ::"V: '~:~-~-~ .v:~ ,, ~ ,, - ...... ~ ,. -:.,..- - '.:. '~Z~ 4~ ,~ J~o~. IZ~/ ~IYO¢' ---'---'- - .... ~ND ] ,j :' -:- ...... - J ' . -. -' r. :--',~'.L 7~ ~J~ ' '7~ ....... [~:~-~ I~11 . ~' ' '~. ~-- . ~ RODERICK VAN TUYL P.C. - .~.~ ~ I~// J ' ~O' / ~ LICENSED LAND SURVEYOR5