HomeMy WebLinkAboutTR-2173 GFBoard Of $outhold Town Trustees
SOUTHOLD, NEW YORK
Mooring No.
PERMIT NO. :i:.2.%.7.]]::]:.-.']i..:[: ............................. DATE: ..~.u,?-..,.~.:~-.,....~_.~.?6
New York~ 1893, and Chapter 404 of the L~ws of the
$ York 1952~ end ~he Soufho d T6wn Ord,nance eh-
'RESUlT N~ ANDRE PLACIN~ OF OBSTRUCTIONS
DN TOWN WATERS AND PUBLIC ~NDS and f~
Board adopted afa meeting hem on ~.u..:~X....3,.~..,...: ....
"·
' Southold
...................................... ;..; .......... :....; .................... N. Y. and subject to the
d Condff~ons listed 'bn file reverse s|~le hereof
- · [own Trustees authorizes and ' ¢ '
.............. permits fhe following:
TO secure a perm~"}~- a""~Z~ead 'On property
submitted. ' . ... - ::: -"
all Jn accordance wJfh ~he defalJed specJf;cafions as.pre~nfed in
,~" IN WITNESS WHEREOF. The sam Board of Trustees here-
_ . by causes frs Corporate Seal fo be aff~xed, and these presen~ fo
/': be subscribed by a malorffy of as
Please tear off and return to the Trustee Office.
Name*of ~reek.
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
GRANDFATHER APPLICATION
TELEPttONE
1. Name of Applicant: ¢~-~
2. Address of Applicant:
3. Telephone Number:
5. Sketch o2 the work including sizes:
6. Mark off on the map attached,
using an X.
S ignature~~~- ~
Please none that there is a $5.00 filing fee, which
fee, for this ~pplication.
where your propervy is located
/
is a one '~ime
Mooring Applications- $5.00 Application Fee and a $5.00 annual renewal
fee each year.
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Halt, 53095 Main Road
P.O. Box 728
Southold. New York t t 971
CREEK STRUCTURES INVENTORY
Current Owner's Name:
Address:
TELEPHONE
f516) 765-1892
Index.' No. ~
Creek:
Purchase Date:
Telephone No.:
Previous Owners:
Date of Field Work: 73
Permit Applicant:
Permit No.:
Permit Specifications:
Specifications Found:
Condition:
CommenTs:
Date
BOABD OF TOWN TRUSTEES
TOWN OF $OUTIIOLD ·
53095 Mai. Road Phone 765d892 ~';? 3 J- 3 4
Son.old. N. Y.
BOARD OF TOWN' TRUSTEES
Mooring Permit No.
Please tear off and return to the Trustee Office.
Board Of Soutfi61d-Town Trustee i :,
$OUTHOLD, NEV/YORK
I'~-~/m--'~~C certify ~hat'the-wor~ as
authorized in ~his permit has been completed and is now ready
for your inspection. Al~o, the number required on this project
is clearly visible. I ~ur~h~r understand this permit is not valid
until this tear off sheet is returned to the Trustee Office.
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