HomeMy WebLinkAboutTR-4040 GF ~,u~,,,~Ae e0~j].F~0L0: score ~..Am'us
John M. B~cilA$~$~ ~'~ s.~isor
Henry P. Smith. Vice President Town Hall. 53095 Main Road
Albert J. Krupski. Jr. P.O. Box 1179
John L. Bednoski. Jr. Southold. New York 11971
lohn B. Tuthill BOARD OF TOWN TRUSTEES Fax (516} 765-1823
Telephone (516) 765-1892 TOWN OF SOLFI~OLD Telephone (516) 765-1800
GRANDFATHER APPLICATION
1. Name of Applicant: ~'>~s."~?/~<S ~, ~FL~}
2. Mailing adaress: ~).O~ "(Rd ~ ~ qe ~I~C O ~ ~/C
3. Address of Property: ~3~ ~ff/~z~ ~z~
4. Tax Map N~er: 1000- ~-~-/~/ Approx.yr.of construct: ~
5. Prior owner if known:
6. Diagr~ of existing structures, including all dimensions, must be
included with this application:
7. Indicate on attached map: Lo, on, ie; reference point, telephone
pole'number, adjacent ~ope~?ers,./.~etc.
Signature of applican~/~y~_~/ Date:
?~_
Please no~e, there is a one time fee of $50.00 for filing this
application.
/,-
5.,
~ .~0
~* °
~ ',.0 ; MAP OF LAND
· ~ ~ SURVEYED ~o~
~ , . GREGORIO $ CHERU5INA LEONARDO
~A~V t EW
~OWN OF ~OUT~OLD. N.~