HomeMy WebLinkAboutTR-2171 GFBoard Of $outhoid Town Trustees
SOUTHOLD, NEW YORK
Mooring No.
........ PERMIT NO....~.~-...7..1..'iL.:]]]..]......:. - ............... DATE: ...~q,~.....g):.i...~..9.86
· ~:i:[!SSUED TO Thomag ~:.' Coff in ............. -
-. - Pursuanf fo ~he provMons of Chapfe~ 615 of file Law~
"~-fhe Sfefe of New York, 1893; and Chaplet 404 of fhe Laws of the
?Sfafe of New York 1952~ and fhe Soufhold Town Ordlnence en-
~fled RE~ULATIN~ AND THE PLACIN~ OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
'm" REMOVAL OF SAND, ~RAVEL OR 'OTHER MATERIALS FROM
~':~NDS UNDER TOWN WATERS;" end M accordance w~fh the
ResoluHon of The B~'~ ~pfe~ afa meefing held 'on
~Terms and Cond~f~ons I~sf~'~""'"~'~-"-fh~' Y' end su~jecf fo fhe
reverse s~de hereof,
of Soufhold Town Trusfees eufhor[ze ' " ' - ,, ·
s aha PermiTs me
submitted.' ~' ~:~ "' 2'': ~' ~ .-: · ·
.all ;n accordance w[fh ~he de~a[[ed specifications as
fhe or;g;naHng appl;caHon
,>~.. ~y c~uses. ,+s Corporef~ S~el fo be afl, xed, end *hese presents ~o
.~'.~/~.be subscr,bed by a malordy of fhe as of
Please tear off and return to the Trustee office.
BOARD OF TOWN' TRUSTEES
TOW~N OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold. New York t 1971
TELEPHONE
(5161765-1801
PLEASE FILL OUT THE FOLLOWING
STATEMENT:
FORM AND RETURN WITH YOUR SIGNED
Was the s~ructure put in
/ No
Yes ~
If no, please explaln on
in accordance to the plan
the reverse side.
submitted?
2. Was structure placed on the applicant's property according
to the plan submitted? ( The distance must be at least
15 feet fromm his. neighbor's line. )
Yes J 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 mark?
Yes NO
If no, please explain on the reverse side.
4. Is the structure high enough so as not to inhibit the growth
of the natural grasses along or below the structure?
Yes ~/~ NO
If no, please explain on the reverse side.
5. Additional comments:
Date
S ig~ature~f Trustee
HENRY P. SMITH. President
JOHN M. BREDEMEYER, Vice-Pres.
PHILLIP J. GOUBEAUD
ALBERT KRUPSKI. JR.
ELLEN M. LARSEN
NAME OF CREEK:
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York t 1971
TELEPHONE
(516~ 765-1892
GRANDFATHER APPLICATION
dock
5. Sketch of the work
2. Addres§ of Applicant: #1)~}~.~
3. Telephone Nmber: (~g*~ ~
4. Year of Construction:
including sizes
HENRY P. SMITH, President
JOHN M. BREDEMEYER. Vice-Pres.
PHILLIP J. GOUBEAUD
ALBERT KRUPSKI, JR.
ELLEN M. LARSEN
TELEPHONE
(516) 765-1892
NAME OF CREEK:
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
GRANDFATHER APPLICATION
dock
2. Addresg of Applicant:
3. Telephone N~be=: ~¢~nP~
4. Year of Construction: /~
5. Sketch of the work including sizes:
Ro~;~ t Y
6. Mark off on the_map attache~, where proper~y is
using an~ ~/"~ your
located
BOARD OF TOWN TRUSTEES
TOWN OF $OUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
CREEK STRUCTURES INVENTORY
Current Owner's Name:
Address:
TELEPHONE
f516~ 765-1892
Index N~
Creek:
Purchase Date:
Telephone No.:
Previous Owners:
Date of Field ~'0Y~k:
Permit Applicanv:
Permit No.:
Permit Specifications:
Specifications Found:
Condition:
CoIiLr~ents:
/
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