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Home My WebLink AboutWorthington, W. Edgar TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. SINGLE TRAILER OR HOUSECAR LOCATION PERMIT Dote ......... September-. 9~'"t9~ ........... Name ..... W'."' EdEal'"WorChi~gt c~ ...................................................................................... St re et ....... ~'Oll~d" 'A~ ................................................................................................................. Town .......... ~, ~,'~ ~,~lel~ f'"N¥ '~¥ ................................................................................................ Your application for a (single trailer) ~ permit was reviewed by the Town Board on ........................ ~t~l~l:~F.....~ ................. 19~...., and ~[(was not) approved. A permit is hereby ~ locate a (singJe trailer)]~, license number .............. X' ........... or serial number ................. X ........................ at ....... ~olL~ld'"A~'~'j-'-~2.t:l:~l~l~k.~...N.,.~-, ....... pursuant to application dated .................................. ~te.l~t~l~O~l,..~.j....].4:)(~,and the following cond it ions: ....... Pe~i't"denim~l" and" $" ~'-i 00' 'ca-~h-'£~e"r~-. he~e~.~,h .... TOWN BOARD, TOWN OF SOUTHOLD '~ '"~"~'Town Clprk ' TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..... Sep.te~be~'...~ ..... 19~I,L. Application No ................................... Approved .................................... , 19 ........ Permit No ......X ........ Disapproved a/c ...S.ep.tember...& ..1.96b. ................................ 3upervisor APPLICATION FOR LOGATION OF SINGLE AUTOMOBILE TRAILER OR HOUSE CAR, OUTSIDE OF TOURIST CAMP. Date .~.~.....~J~. ...................... , 19J~..~. 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 and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o 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, ordinances and regulations. (S~gnature~6f applicant) ./' (Address) State whether applicant is owner, lessee or agent ........ ~'...~/~¢,~....~/~.. ........................................................... Name of Owner of premises If applicant is corporate, signature of du~ authorized officer. (Name and title of corporate officer) 1. Location of rand on which proposed trailer will be located ....~......~...:,~../. .......... ¥ / Street and number ................... i::~l,4,4,,<~J~. ...... C2,,¢'~..~. · .......... ~ ........................................................ 2. 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. Period of time trailer is to be located on premises .......... ~L..c.~......J.....[.~ ...................... 3. Fee ............................................ (To be paid on filing application) 4. Dimensions of trailer, length.....~.~,' .................... width ...... ~....~ ................... height .......... /..Z ................. Registration Number ............................................ Serial Number ............................................................ 6. 7. 8. b. Date of purchase or lease of land ......... ,..~,/~o~_/.~ ....... ~.. ............ / 9 ~:/¢,~' Zone or use district in which premises are situated ......... ~~..~ ..................................... Does proposed use violate any zoning law, ordinance, or regulation? .............. ..~,). ;~;.~ ............................. Method of Sewerage disposal ~- L~n'~ Source of Water Supply ...... ,.~-~;:~..../..'~=~¢...,,~'Z,!....~r~.,~m¢~/?~_/~,/ ........................... Source of Electricity ..~-.1,~,~¢...:~.../~.c~.-,.~x~..~O~... / 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. ST^T~ OF NEW YC~.~: COUNTY OF SUFFOLK ~4J. ' ~/ ...~.....c~..... : ~ being dbl'/sw~r~I deposes and says that he is tho oppficont ~med.~bove. He i$ the . ............................ ...d~/~.....~.&.~..; ........ ; ......................................... (owner or lessee or agent) of said owner or owners, and is duly authorized to make and file this appl!ccrtion; 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 r~ahri~r S~t' ~b~th in the applica*ion filed herewith. Sworn to befbr~ m6 tills ............ ~.~..~. ............. day of ......... ......................, ...... ..... ...... : ........ .................... NOTARY PUBLIC, State of New York No. 52-284]400, Suffolk County / ? qnmmission Expires March 30, 19 ~ TOWN OF SOUTHOLD TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Examined ..... J~.~l J:l.t, IL~.~I~.... ~ ..... 19.(:~'... Approved .................................... , 19 ........ Permit No .......~.. ....... Application No .........., ......... ',.~ ............ Disapproved o/c ..i~.g~.l~..~RJ~...~$...~,~.(~t~j' ................................ : Supervisor APPLICATION FOR LOCATION OF SINGLE AUTOMOBILE TRAILER OR HOUSE CAR, OUTSIDE OF TOURIST CAMP. 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 and of buildings on premises, relationship to adjoining p~'emises or public streets or areas, and giving a' detailed description of layout of property and propose~ ocation 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 applica~t. 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 app cant) :~ ~' (Address) ./ State whether applicant is owner, lessee or agent ................ (.~t.~m.~ ............................................... Name of Owner of prem,ses ....r~.~.d~.,Lc]~..~.....~]~.c,~..~.g.~..~",'.Z~¢/..~,-~,.~,~.__ .......................... If applicant is corporate, signature of ct~ly authorized officer. (Name and title of corporate officer) l. Location of land on which proposed trailer will be located ............... r. t. ...... Street and number ..................... ..~..~,~ ...... C]L,~.~:c(¢~ ........................ ~ ..................................... 2. State existing use and occupancy of premises and intended use and occupancy1 of proposed trailer: a. Existing use and occupancy .............................................. ~ .................................. ., ~. "~ ~/ , b. Intended use and occupancy ........ ..... c. Period of time trailer is to be located on premises L.....,~.. 3.Fee ............................................ (To be paid on filing application) t / -'( 4. Dimensions of trailer, length .......... ~..L~ ............... width ......... ~...~......~ .......... height ........ ./../. .................... Registration Number ............................................ Serial Number ............................................................ 6. 7. 8. 9. Date of purchase or lease of land ........ ..,.,~:~........~.. ........... ~....~."...~./..~>~..~. Zone or use district in which premises ore situated ............. /;'~'.J~22,~J~.tk~ ............................. Does proposed use violate any zoning law, ordinance or regulation? ................ ~..&.~'~; ........................... a'. Method of Sewerage disposal ................. ..~..?.~..~.....,C~,~.T;~i ............................................. b. Source of Water Supply ........... .~e':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 buses. STATE OF NEW YORK 'l. ss. COUNTY OF SUFFOLK ........................ : ............................. berng ddJy 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 ~nanner set forth in the application filed herewith. Sworn to before me {his ........... .~,...../~...~.. .............. day of .......... ................... . ..... ...... ~ ,/" ~ , .... ~' (Signature) z~' ..................... !:~. Z./, L ,.~i/.. ,. ~,~..1~. L,~ ~q~ry'Ru ie) d ............... RUTH 1~ MYERS 1,10TAJ~Y PUBLIC~ ~e of New York Nc. 52-2841400~ Suffolk County ~/}~' ~mmissJon Expires March 30, 19