HomeMy WebLinkAboutTR-5227EIssued To~h:~L.c~uh~b~ Date~
Address z ~ . /-
THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION
TOWN TRUSTEES OFFICE,TOWN OF SOUTHOLD
SOUTHOLD. N.Y. 11971
TEL.: 765-1892
Board Of $outhoid Town Trustees
SOUTHOLD, NEW YORK
ISSU[:D TO ASTRID GADDI$ ........................................................
utltarizatta
;L-~L,R-~ ~n~ WA~S AND ~B~ ~DS e~ ~
'" 'G~L~ s'~'~'~ e"~v'-~.o, omD UA~ ~
~ ~DER TOW. WA~;~, -." ,. ~ "~ ~
ZOQ~......., ~nd in c~sldmet~n ~ the mm ~ $....~-:-~ ..... ~ld by
A~t~ G~d d~ .................................................. · ...................
_ Laurel ~ Y. end
~ secondary bulkheads to terrace bluff in levels... R.eturn ..wnlls ,to
built on east and west side connecting new waLK to norln aha
All materiai will be 1.5 CCA lumber. A set of stairs will be
in th 's..a~n=,~_~.l~.~®a~l~l~' ~t~]~~d~ass'
Montauk daisies and Rosa Rugosa ........ -' · ''
. IN WITNESS WHEREOF, The ,~kl B~wd M Tmsl~ss I~ ...
· Hen Smith- .Absent
ALI~ 3 I 200~
c~n~o ~: ¢~,~ q~j _ ~s: DESCRIBED PROPER~
NOV 2 6 2012
TROPICAL STORM SANDY EMERGENCY APPLICATION
Valid thru June 1, 2013
Property Owner Name: /~
Pe~ahent Mailing Address:
Phone Number(s):
Properly Address: ~g ~/~
Suffolk County Tax Map Number:
Agent (if applicable)
Address:
Phone Number(s):
Board of Trustee Permit Number(s):
Will any part of this project require a Building Permit?
HOW much fill will be required? / '~--~" ",./
Project Description: /~
County of Suffolk
State of New York
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE
TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK
WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY
BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT
AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES
HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING
UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS
APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR
REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.
Signature of Property Owner
SWORN TO BEFORE ME THIS
Notary Public
LUCILLE BRAND
Notllry Public - 8tllte of New York
No. 01BR4736514
Qualified In Suffolk Counb/
My CommisSion Explre~ II~y 31, 2015
AUTHORIZATION
(where the applicant is not the owner)
I, residing at.
(print owner of property) (mailing address)
do hereby authorize
(Agent)
to apply for permit(s) from the
Southold Board of Town Trustees on my behalf.
(Owner's signature)