Loading...
HomeMy WebLinkAboutTR-8183ESOUTHOLD TRUS' Issued To ~ I~An* P~llA,.~' Date~ Address~ sc'r'~,11~ 1 Z,~ I1-t THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION TOWN TRUSTEES OFFICE.TOWN OF SOUTHOLD SOUTHOLD, N.Y. 11971. TEL.: 765-1892 ECE~VE UAY 3 1 2013 TROPICAL STORM SANDY EMERGENCY APPLICATION Valid thru June 1, 2013 Pmperty Owner Name: ~O. lO. H~r~ Permanent Mailing Address: g~$O Phone Number(s): g 3i ' 2qg-709g Suffolk County Tax Map Number:, 1000 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? I ~© cc~bic var~,% / Project Description: R~::~I(~C~:? ~d ;~ IOq/~? bulk ~n, eod whi'ch wry.c;' wr~ch ~wrl,w b'w ~r'~v. / / I County of Suffolk State of New York ~cti~ ~r~ ?~ ~to.~ ~ErS~DU~Y SWORN OEPOSES ~D ~F~S THAT H~SHE I~ ~m ~mc~ ~o~ ~ ~o~ WILL BE DONE ~ THE ~ER SET FORTH ~ THIS APPLICATION A~ AS ~Y BE ~PRO~D BY THE SOU~OLD TO~ BO~ OF ~USTEES. ~ ~PLIC~T AG~ ~ HOLD ~E ~ OF SOU~OLD AND ~E TO~ ~US~ES ~,~SS ~ F~E FROM ~ AND ~L D~GES ~ CLA~S ~IS~G ~D~ OR BY ~E OF SA~ PE~(S), · G~TED. ~ ~LE~G ~IS APPLICATION, I HEREBY AUrORaE ~E ~USTEES, ~E~ AGE~(S) OR ~P~SE~AT~(S), TO E~R O~O ~ PROPER~ TO ~SPE~ ~E P~SES ~ CON~ION W~H REV~W OF ~S ~PLICATION. SWORN TO BEFORE ME THIS Si~nature of Prope~:y Owner DAY OF ( 20 2007 ul~l~l YOUNG a YOUNG .,ooo,?.A.,~. ,,,,..,,. RIV'ERH~D, NEW yOR~