HomeMy WebLinkAboutTR-8135ESOUTHOLD TRUST .
Issued To'~:~g,~m:~a~~ Date.~~
Address
THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION
TOWN TRUSTEES OFFICE,TOWN OF SOUTHOLD
SOUTHOLD, N.Y. 11971
TEL.: 765-1892
~..~UFF. CZ),TA~ NIAF DATA.
2013
James Y. King, President
BOb Ghosio, Jr., Vic~-Presi<lent
Dave L~rgen
John Bredemeyer
Michael d. Domino
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631 ) 765-1892
Fax (631) 765-6641
BOARD OF TOM~I TRUSTEES
I~ICANE SANDY EMERGENCY APP T~
Valid thru June 1, 2013 so~," '~ '.~,
Property Owner Name:
Permanent Mailing Address:
Agent (if applicable)
Address:
Phone Number(s}:
Phone Number(s): . .~ Ih. <~-~ - 0
Property Address:/~)TF ~'~)O.~gVV_._
Suffolk County Tax Map Number: 1000-
~ Box
Board of Trustee Permit Number(s):
Will any part of this project require a Building Permit? ~,~'O
How much fill will be required? 1~90
Revision
Date: 4/26/2013
Sca~e:
Lands~pe Plan: 4~26~13
~rnman
Landscape Design by:
David Qchanow~cz
' * ' n
~"= ~o' Creabve Environmental Deslg