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Board Of Southold Town Trustees
SOUTHOLD, NEW YORK
Mooring No. N/A
PERMIT NO ........... ~..2...0..'~. ............ DATE: .&~.g.~...g.~.~....~!8.6
' 1(~1 g~ TC% Henry Wf Burden '
Pursuanffofhe
PLACJ
)S and the
'OTHER' MATERIALS 'FROM
WATERS? and !in accordance Wlth the
Resolution of The Board adopted a~r a meeting '" Aug. 28,
nma on ........... : ........... : ......
:.' 86, .... f SL5'0°" 'pald by
19....,.~...., and m cons derahon of lhe sum o
................................................. ~.~L.~.:...?.~i~%......:....~ .......... :.: ............ : ..................................
Of Orient ·
................................................................................ N. Y. and sub ect to the
Terms and Cond~tons Isled on thee reverse s de hereof
of Soufhold Town Trustees authorizes and ~ermltsfhe following:
Approval to secure a permit f~r a'S%ip 45' wide x 50' long
, ,yith a l~2'...x 6' floating .doqk & ramp 20' X 22' and 2nd.
slip 25' wide witht a 24ft. x 6' floating dock and ramp
at0. ft. x %2" all in accordance with~ t.h.e application submitte
J in accordance with ~he defaiJed specif[Cahons as presented in
~r The 0riglnafing applicaflon.
IN ..WITNESS WHEREOF, The s?.idi Board of Trustees here-
by causes, ifs Corporate S.e. al to be aff}~e~l and:: these p.r&sents to
be subscr bed by'a~majordy ~f the sa d Board ~s of, fhs date. '
Trustees
Please tear off and return to the Trustee Office.
Board Of Southc ld-Town Trustees'
$OUTHOLD, NEW YORK
Mooring Permit No. Date:
Mooring No.
I, certify that'the-work as
authorized in this permit has been completed and is now ready
for your inspection. Also, the number required on this project
is clearly visible. I further unders=and this permit is not valid
until ~his tear off sheet is returned to the Trustee Office..
~£ ~reek
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York I i971
GRANDFATHER APPLICATION
IELEPHONE
(516) 765-1892
8ock
1. Name o£ Applicant: /7/~A//~y tx! ,/'~ ~//~e/t/
2. Address of Applicant: y~ /'~/f//~ f~.~/~/d~/~/~yT//~f
4. Year of Construction: /.~9~? .-~/
5. Sketch of the work including sizes:
6. Mark off on the map attached, where your property is located
using an X.
Please no~e tha~ therelis a $5.00 filing fee, which
fee, for this applicatXon.
zs a one time
~'~B'(~ARD OF TOWN TRUSTEES
! TOW~ o~ so~r~o~u
53095 Main Road Phone 7654892
Date
~For O~_ /~ ~~ BOARD OF TOWN TRUSTEES
Cash ~ ~_eck ~ ~~~,
Dollars $ ~ '
BOARD OF TOWN' TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold. New York 11971
TELEPHONE
(516} 765-1801
PLEASE FILL OUT THE FOLLOWING FORM AND RETURN WITH YOUR SIGNED
STATEMENT:
/
1. Was the str~ture put in in accordance to the plan submitted?
Yes No
If no, please explain on the reverse side.
2. Was structure placed on the applicant's property according
to the plan submitted? ( The distance must be at least
15 feet from hi~ neighbor's line. )
Yes ~/ NO
If no, please explain on the reverse side.
3. Is there easy access over or around the structure, so that
pedestrians can move along the public's right of way below.
high water marc2.
Yes ~// NO
If no, please explain on the reverse side.
4. Is the structur~/fiigh enough so as not to inhibit the growth
of the natura/1/grasses along or below the structure?
Yes ~/ NO
If no, please explain on the reverse side.
5. Additional comments: