HomeMy WebLinkAboutTR-81-3-6 GFBoard Of $outhold Town Trustees
SOUTHOLD, NEW YORK
PERMIT NO, ~!.~.-~-~ DATE: ,. L,~- i.H:~/'~
ISSUED TO ..~'~..,..~..~.~ ~ ~
Pursuant fo the provisions of Chap,far 615 of the Laws of
the S,fafe of New York, 1893; and Chapter 404 of the Laws of the
S,fafe of New York 1952; and the Sou,fhold Town Ordinance eh-
rifled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and the
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS:" and in accordance wl,fh 'the
Resolution of The Board adopted afa meering held om
19 and in ¢ons'deraf~on of the sum of $ ~-pald by
of ............................................... N.Y. and subiec,f 'fo the
Terms and CondJrions listed on the reverse side hereof,
of Soufhold Town Trustees aufhorlzes and permits the following:
all in accordance wi,th fha detailed specificarions as presented in
fha originaring applicarion.
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes ifs Corporate Seal fo be affixed, and these presents fo
be subscribed by a majority of. the said Board as of this date.
_
.................................... ...................................
TRUSTEES
John M. Bredemeyer, III, President SCOTt L. HARRIS
Henry P. Smith. Vice President Supervisor
Albert J. KrupskL Jr.
John L. Bednoski. Jr. Town Hall. 53095 Main Road
John B. Tuthill P.O. Box 1179
Somhold, New York 11971
'BOARD OF TOWN TRUSTEES Fax (516)765-1823
Telephone 1516) 765-1892 TOWN OF SOUTHOLD Telephone ~516) 765-1800
-GRANDFATHER APPLICATION
3. Address of Property: ,~/~j ~<~/~ .~d~/~.e~r~ ~
5. Prior owner if known:
6. Diagr~ of existing structures, including all dimensions, must be
included with this application:
7. Indicate on attached map: Location, ie; reference point,- telephone
pole number, adjacent property owners, etc.
Signature of applicant: ? ~Q2~~~~ Date:
' *applicationPlSase note,, there is a one time fee of $50.00 for filing this