HomeMy WebLinkAboutL'Eplattenier, VictorTOWN OF SOUTHOLD
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined .................................... , 19 ........
Approved .................................... , 19 ........ Permit No .................
Disapproved a/c ..........................................................................
Application No .....................................
Supervisor
APPLICATION FOR LOCATION OF SINGLE AUTOMOBILE TRAILER OR HOUSE CAR,
OUTSIDE OF TOURIST GAMP.
Dote..d.~.~.~..:'.~.-~.....Z ........... ,
Instruction*
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 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 lows, ordinances and
regulations.
.... .............
(Signature of applicanf~'
.........
(Address) ·
Slate whether applicant is owner, lessee or agent ............ ,..~...~-./.~, ..................................................................
Name of Owner of premises ....... .~.:/.f:./..~t~ ....... ..~..,..,~...~..~,?'.f:././...~'~(*.~./.',...~.'~ ......................................
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 ........ . ................. ~.. 4',~....,,..~.~,..t...'~. .....
Street and number . .~...~..~.C......~.-/.4L~..x....~.4.~.~:.,q/.~.....~.:.'Z4~;..~.~:...~..~'.......~..~¢...~'.~;~.~?.g:~.z~. ......
2. State existing use and occupancy of premises and intended use and occu~ncy of proposed trailer:
a. Existing use and ~cupancy ....x..~;.~,.~.~.~....~.~.~:.~/,.~.~'..';~. ....................................
c. Period of time trailer is to be located on premises .... ~ .....~,.. ~.,= .............................................
Fee ............................................ (To be paid on filing application)
Dimensions of trailer, length ...... ............. width ......... ./~...- ................... height ..: .......................
Registration Number ..X~J..~..~..r....~....~.. ............. Serial Numbe), .,Z~..,~....,.~.~.~ ......... './...'.~.../.. ...............
6. Date of purchase or lease of land ~7..C;~¢Z~7, /~./. '~
7. Zone o, use district in which premises are situated....(.~.~.,?/.~.:.~.~.:."7~(. ,~.... ........................................
8. Does proposed use violate any zoning law, ordinance or regulation? ...~../..~., .......................................
9. a. Method of Sewerage disposal ..~.[.~ ...... ~:..~;~..~:~.~<../~..~..~(~(..:'~:....~;c~,~/,,,.,,
..... ....... .
c. Source of E ectr cty /~. x~:~. ~ ,/~ An. 6.~. ..............................................
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 clearl' ion of proposed trailer on prem-
ises, showing distances from all buildings and property lines.
STATE OF NEW
COUNTY OF SUFFOLK
....... ..~.....C. ~ ......................................... being duly sworn, deposes and says that
he is the applicant named above. He is the ..... C~..~(,~...~'.~J~ .......................................................
(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 ......... Z..~. .................... day of -- , - )
:7 ' .~ ~ (~ignature)
.... ...................
(Notary Public) ~'
JUDITH T. TERRY
TOWN OF SOUTHOLD
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined .................................... , 19 ........
Approved .................................... , 19 ........ Permit No .................
Disapproved a/c ..........................................................................
Application No .....................................
Supervisor
APPLICATION FOR LOCATION 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 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, ordinonces and
regulations.
~..~C,/~. ....... ~.......',. ~,,~...~,~..~..~¢ .~.~..~..',~. ..................
(Signature of applic~t)
........ ~.,.......~..L...w.,....~.g.~ ...... ....... ~ .....
(Address)
State whether applicant is owner, lessee or agent ..~..~.x ........ ~ ...................................................................
Name of ~ner of premises ..... -- ~j(.(:~=~.tZ~ ......... ~, ............. ~..~..~.~~:.~:~.~. .........................
If applicant is corporate, signature of duly authorized officer
-~/~ ~ -~'~2 :'4 ,~,, ( C-
1. Location of land on which proposed trailer will be located ,..~.~,. ............. .~ ................................... .-~...~ ....
' /../.., ' ,,
Street and number 4/-//<z f f~ ~.?.¢ ./.~: : ~',"~ ~' ~,-*:.%~-~ ~¢~':z,~v,
................................................................................. ; .......
2. State existing use and occupancy of premises and intended use and occupancy of proposed trailer:
a. Existing use and occupancy .............. ~. :,~..~ .......... ~ ...... ~:~./2.~,.,~.~.~. ..................................
b. Intended use and occupancy ....~...~..°...~.~.~r~, ....... .~.~..?....~.:..:....~/.~}..~.~.~...':.~.~:...,,~?./~.~..~.~...........'-' ~' t ' ' ~ ~
c. Period of time trailer is to be located on premises .:x .,~2.~.~...~.Z:=!i~- ....................................
Fee ............................................ (To be paid on filing application)
Dimensions of trailer, length ....... i~.4~.. ............... width ......... ~ ....................... height ...>..~ ....................
Registration Number L.2.... '~...,.'...C.....'.../. .............. Serial Number ...~..../~......~..m..,.., ~./..Z~.....~....~.~'. .............
6.
7.
8.
9.
Date of purchase or lease of land ............ ~...~. ~...~ ................................ ~ .........
Zone or use district in which premises are situated ........ .~.[. ¢ ......................................
Does proposed use violate any zoning law, ordinance or regulation? ...... .M~..~',~. ...................................
a. Method of Sewerage disposal ....~.O./~.~',...(..,Z~....<~.ZjC..~.-.~.....~...'.~-/%./.~Q.~,..-...~..'.~Z' ~.~..~./~/~ ~-~
........ ....... .......
c ....... ~ ........................................................................ '.EE ......
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or prdposed, 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 [ocat, ion of proposed tra er on prem-
ises, showing distances from all buildings and property lines.
STATE OF NEW YORK
COUNTY OF SUFFOLK
~. ............................................ being duly swarth, ~epos~s and says that
he is the applicant named above. He is the ....... k~.....~/,,Z~..~/~ .......................................................................
(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 - · ~ ) ~'
(S(dgnat ute)
JUDITH T. T~RR~
Nota~ Public, State Of Hm~ York
r~. 52-C3-~SG3 LL,[fo'.k Count~
Commission [xp;res March 30, 19:~
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