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HomeMy WebLinkAboutStrickland, AdelaideTOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N.Y. SINGLE TRAILER OR HOUSECAR LOCATION PERMIT Date ......... D.ecemher..23.,...19.6.~ ............ Name ..Adelaide S. tr. tck]end . ... Street ....... i~V.T. Road (Johnta Rd) ....................... Town ......... ~.ttltUCk,.....II~ Z, .............................................................................................. Your application for a (single trailer) (I~i~,~I~ permit was reviewed by the Town Board on ............................ ~.~b.e,~.....29 ............ , 19.1~-.., and (was) (~r~r,Y~l~) approved. A permit is hereby issued to locate a (single trailer) (~), license number ............................ or serial number ............................................ at....,~..~l.:~.~...~..~.~.$.~....~..~..a.~...O.~'.~...$./~... .Hain..Road...(...~hn !. ~...~ad ) ..... Hat ti~.uck ~...N..~. ................................................... pursuant to application dated ........................... De. cemb.~.....21...19.6.1+..., and the following conditions: ... P ~,, r.l~li.t~.. ~l ,,} au~.d.. ~.or...~...~l~n~b s.. f'rom..~e.o,...p2j-ll~ ............................... TOWN BOARD, TOWN OF $OUTHOLD Town/Clerk Please send serial number of trailer to Building Inspector immediately TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .................................... , 19 ........ Application No ................................... Approved D..e.c.~m_b..e..r....2.~ ............... , 19~.b.....Permit No...~ ...... p. . y. .e. .d. . . ?. .r. . . .s. .x. . . .m. .q.n. h .s. . . .n. . [ . f .r. .m. v Supervisor APPMC~TION FOR LOCATION OF SINGLE AUTOMOBILE TRAILER OR HOUSE CAR, OUTSIDE OF TOURIST CAMP. ,. ......................................... , 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 o:F 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 E~oard 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 cr 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 applic,able laws, ordinances and regulations. .......... ~Signature of aRollcant). , ~' "(Address) / ~ cz ~ State whether applicant is owner lessee or agent...~l.u~.¢~.~....~... ............................................................... .ome of Owner of premises .... 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 ~.~?..:...C~¢~...~... '~.~x~. Street and number'~...:.,~.~../~..~.. ........ -~,¢~ ..~..........~..-~. ................................................. State existing use and occupancy of premises and intended use and occupancy of proposed trailer: a. Existing use and occupancy .............................................................................................................. b. Intended use and occupancy ............................................................................................................ Per' d of time trailer is to be located on premises ~./...~:..~..: .......................................................... Fee ..~.~ ...................................... (To be paid on filing application) Dimensions of trailer, length...~.'~.. .................. width .../...~.. ....................... height ................................ Registration Number ............................................ Serial Number ............................................................ 5. Size of lot: FronY ...............~.~..b ................... Rear ..... ~ ...................... Depth ...................... : .......... 6. Date of purchase or lease of land ............................................................................................................ 7. Zone or use district in which premises are s tuoted ...~;.v~ .................. 8. Does proposed use violate any zoning law, ordinance or regulation? ...................................................... 9. a. Method of Sewerage disposal ~'~_ ' ~'~Tt _) b. Source of Woter Supply ...... ?~ '- ~ .Q....~C... ............................................................................. : ................ c. Source of Electric ty ~:~ ..~./ ................................ 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 oil buildings and property lines. ,Jo STATE OF NEW YORK 1 COUNTY OF SUFFOLKi'ss' /' ............................................ · ..~ ................... .~ .............. .~ .............. being duly sworn, deposes and says that //he is the applicant named above..~e is the) ............................... lessee 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 ..... .~;e~....~.~.~'.'.~. ............. do'/of ................. ~ ..... ~ ............... ~. ...... , ~....~... .4~1~~~~~ ........ . ~-~ ~ (Signature) · ........... ~:(.~C.~_b..~.~C.~:~.,.~.~. ~.,.~.>~:s ~ ........ (~ato~ Public) TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .................................... , 19 ........ Application No ................................... Approved O..e..c...e~...b..e..r....2.~ ................ 19..6~......Permit No..~-.~... ...... ~.:l~l~r. cw.~., f. er...: J.~..~n~ h,~..pn.l~...f.r..~...~.~ ~_ ..................... .............................................................. ........... ..................... APPLIGATION FOR LOCATION OF SINGLE AUTOMOBILE TRAILER OR HOUSE CAR, OUTSIDE OF TOURIST CAMP. D~te ~. ,.....'~..~.: ..:...~ ............ , 19..~....~.. Instructions a. This application must be completely filled in by typewriter or in ink end 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 cr 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. (S~gnature of applicant) __ ,~ ....... ........... · (Address) ' State whether applicant is owqe. c~lessee or agent..~.?..:4-~.L...~/..:..~... ............................................................... Name of Owner of premisesq~......~.~'.,/..~..~,/~...~.~..~.:..... .~..~...~~-'~. ............ If applicant is corporate, signature of duly authorized officer. (Name and title of corporate officer) / State existing use and occupancy of premises and intended use and occupancy of proposed trailer: a. Existing use and occupancy .............................................................................................................. b. Intended use and occupancy ............................................................................................................ c. P.~z riod of time trailer is to be located on premises ./.:~..: ........................................................... / Fee .~. ....................................... (To be paid on fihng application) Dimensions of trailer, length ........ ~..:~ ................ width ........ /..~. .................. height ................................ Registration Number ............................................ Serial Number ............................................................ 5. Size of lot: Frontc~Cc~.-u,,~r~../.~...J. ............... Rear ...... .~...q~.~. .............. 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 zon/~g~ law, ordinance, or regulation? ...................................................... 9. a Method of Sewerage d sposa .~.~(.J..~f.~,,¢~.) ............................................................................................ b. Sou rce of Water Supply ..g./.'/~..~... ................................................................................................. c. Source of Electricity..~-~ZL~ ................................................................................................... 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, ~how'ng al'stances from all buildings and property lines. STATE OF NEW YORK }ss. COUNTY OF SUFFOLK (~,,.~.,~ C~' .4~_ ~ ,/( '~.4., ,!_~,..~,.,~.~,f,~ being duly Sworn, deposes and says thor he is the ,applicant named obove,,~-Ie is the ........ ~~,~,~, ............................................................ (m~n~or lessee of said owner or owners, and is duly authorized to mOke and file this appl:icofion; and that all statements confined in this application are true to the best of his knowledge and belief; and that the trailer will be located i~' the n~a'r~'~'er set forth in the al~alico,tion filed herewith. SwoFn to before t:n~ f~Js ........ :.~-~....~..z,..~....A_ ......... day of ~' ~- ................... ........ ........ ............ ....... (Nota~ Public)