HomeMy WebLinkAboutTR-31-14-8.2 GFBoard
SOUTHOLD, NEW YORK
PERMIT NO.... ~..!.;;. ?(.~?'~ DATE:
ISSUED TO .......... ~..:..... ~C.'LfL~ ._.....~ ~.~ ;.~,.I ....................................................
Pursuant to ~he provisions of Ckapter 615 of the Laws of
the State of New York 1893; and Chapt&r 404 of the L.aws of the
.S.f. ate of New york 1952; and the SoufJ~old Town Ordinance en-
htled "REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC LANDS and fha
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;" and in accordance with the
Resolution of The Board adopted at a meeting held on ...1~.=.!~ ...........
19..~, and in considered'ion of the sum of $. £~'~*.~p~.. paid by
of ............................................................................ N. Y. and subject to 'the
Terms and Conditions listed on the reverse side hereof,
of Southold Town Trustees authorizes and permits the following:
all in accordance with the defaiJed specifications as presented in
the originating application.
IN WITNESS WHEREOF, The said Board of Trustees here-
by causes.lts Corporate S..eal to be affixed, and these presents to
be subscribed by a maior,fy of the said Board as of this date.
Trustees
TRUSTEES
lohn M. Bredemeyer. III. President
Henry P. Smith, Vice President
Albert J. Krupski. Jr.
John L. Bednosld, Jr.
John B. Tut. hill
Telephone (5t6) 765-1892
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
SCOTI' L. HARRIS
Supervisor
Town Hall, 53095 Main Road
P.O. Box 1179
Southold. New York 11971
Fax (516~ 765-1823
Telephone (516) 765-1800
Name of Applicant:
Mailing address:
Address of Property: ~ /~7/~
GRANDFATHER APPLICATION
Tel. No: ¥77'- ? ~z,~ ~'-
Tax Map Number:
P~ior owner if known:
Diagram of existing structures,
included with this application:
3 / /
1000- ~ ' pro~.yr.of construct:
including all dimensions, must be
Indicate on attached map: Location, ie; reference point,
pole number, adjacent property owners, etc.
Signature of applicant: Date:
Please note,
application.
telephone
there is a one time fee o~ $50.00 for filing this
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