HomeMy WebLinkAboutTR-7939ESOUTHOLD TR.USTEES
IsSued To.~~.~',,~:~,.gJ.~,~~ Date~J~
Address
THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION
TOWN TRUSTEES OFFICE,TOWN OF SOUTHOLD
SOUTHOLD, N.Y. 11971
TEl.: 765-1892
51TUATE= 5,OUTHOLO
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SUFFOLK COUNT'K, N'r'
."':~JRVEYED 03-01-2004
TOPO 0-1-06-2006
P~,OF'O.~EO ~AP-,A~E 01-25-200-/
FOUNDATION LO0. IO-OS-200q
FINAL OGT. ~6, 2010
E:~JPFOL~ OOUNT'd TA~ ~
lO00- cig- 6- I
.m~UFFOLK C, OUNT'Y HEALTH OEPT.
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FLOOD ZONE A5 ~HOI, NN ON FEHA FI~,H
klAP NU~F:R :~IO~GOI,64H ~EPT. 25, 200q
A~EA =2&,1¢0 ~.F. or 0.~0
~PHIC 5CAL.E I"=
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JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S. LIC. NO. 50202
RIVERHEAD, N.Y. 1190t 369-8288 Fax 369-8287
REF.C:XDocuments and Sert[ngs\Owner~vly Documents~Vly DropboxX04\lM\04-124 final map.pro
NOV 1 6 2012
TROPICAL STORM SANDY EMERGENCY APPLICATION
Valid thru June 1, 2013
Property Owner Name: "'~o'~ "~ k .~L.¢~\ ~._.E~
Permanent Mailing Address: ~ ~::, ~'~)~ ~
Phone Number(s): ~ ~'~--1 - ~
Propedy Address: ~ '~ ~ L~
Suffolk County Tax Map Number: 1000 - d~, ~-
Agent (if applicable) ~¢~ '~)~ (~/
Address: ~O ~/ ~o~, ~o~
Phone Number(s): (~%~ q'5o,J- ~¢ ~ ~
Board of Trustee Permit Number(s):
Will any pa~ of this project require a Building Permit?
How much fill will be required?
Project Description:
AUTHORIZA'HON
(whcrc thc ~lppJicallt is not the owner)
l' ~--.~ ff-d-*~.~..0 rcsidiag at ~~z~-
(print ow~ of prop~) (ma~]ing address)
~~~do h~by auLhoHze
(Agcnl)
~~-~L~ ~ apply tbr
SouO~old ~mM of Town Tm~co on my
NOU-16-2012 11:50AH From: 1 718 893 57B4
ID:BURGER CONSTRUCTION Pa~e:001 R=OTZ