HomeMy WebLinkAboutTR-4051 GFBoard Of Southo[d Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO. 405]. DATE: .....~./6(9g ..........
~SSUED TO ~A,~....~..:.]~.:~
Pursuanf fo +~ provisions o~ Chapfer 6]5 o~ fhe Laws o~
fhe S+afe o~ New Yor~ 1893; and Chaplet 4~ o{ f~e L~ws of
Sfefe o~ ~ew Yor~ 1952: e~ +he Sou+hold Tow~ Or&nence eh-
filled "RE~U~TIN~ AND THE PLACIN~ OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUaLIC LANDS and
RE~OVAL OF SAND, ~RAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and ~n accordance w~ fhe
ResoJufion~ The goer~ adopfed efa meef~ng he~ on
g~s~. ~. g[e. se] .......................... : ..........
o~ ............... G~ee~: N.Y. and su~[ecf
Terms an~ Cond[~]o~ Jisfed on ~he ~verse side ~ereo~,
o~ SoufhoJd Town Trusfees aufhorJzes and permJfs fhe foJJowing:
~eb~ild e~ist~g b:lk~e~d ~t t~e e~d
ell in accordance wifh the derailed spec~fice+]ons as pre~nfed
fhe orynafin~ appJicaf~on.
~ WIT~ESS ~HEREOF, The sai~ 8o~r~ o~ Trustees here-
by c~uses ~fs Corporafe Seal fo be efTixed, and +~ese presen+~
be subscribed by a ma~orlfy o~ said 8oard as o~
TRUSTEES SCOTt L. HARRIS
John M. Bredemeyer. III. President Supervisor
Hemy P. Smith. Vice President Town Flail. 53095 Main Road
Albert J. Krupski, Jr. P.O. Box 1179
John L. Bednoski, Jr. Southold. New York 11971
John B. Tuthill BOARD OF TOWN TRUSTEES Fax (516) 765-1823
Telephone (516) 765-1892 TOWN OF SOUTHOLD Telephone (516) 765-1800
GRANDFATHER APPLICATION
l. Name of Applicant: ~S~ GA)D D /ES 4-2_
2. Mailing address: nO. ~0~ //
3. Address of Property:
4. Tax Map N~er: 1000-
5. Prior owner if kno~:
6. Diagr~ of existing structures, including ~11 dimensions, must be
included with this application:
[
7. Indicate on attached map: LocationFhie; reference point, telephone
, etc.
pole number, adjacent property owng'r~
Signature of applicant: Date:
* Please none, there is a one time fee of $50.00 for filing this
application.