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HomeMy WebLinkAboutTR-4052 GFBoard Of Southold Town Trustees SOUTH©LD, NEW YORK PERM)T NO. 4052 DATEs . )SSUED TO .. )4A~J~[~qxT,.. h~g.~,5.~ ................... ~ ....................... fff~ed "REGULAJ~N~ AND THE PLACING OF OBSTRUCTIONS ~N AND ON TOWN WATERS AND PUBLIC LANDS a~ ~'~ REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDE~ TOWN WA~RS:" a~ [, accordance Re~olu~[o~ ~f The Board ad,pled afa meef[n~ he]d e~ ...7/30 .... M~.rilyn Mor scb. ~ ~ou~ho!~ N.Y. and ~ub~ecf Terms and Condff~ons ~ste~ on fha reverse of Soufho~d Town T~usfees aufhoHze~ ~nd perm[rs +he ~N W~TNESS WH~REOF~ The s~]d Board of Trusfees by causes ~fs Corporate Sea~ fo be affixed, and ~e~e ~r~senf~ TRUSTEES , ! .......... { L. HARRIS John M. Bredemeyer, III, President ~ ~J~Jk. I o ~woa. ~ i~/~ Henry P. Smith, Vice President ~ t Tov~n H~I, 53095 Main Road Albert J. ICrupski, Jr. ' '--T ~' ~'~O. Box 1179 John L. Bednoski, Jr. TOW~ 0F S0U~ ~, 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 ER-CONSULTANTS lNG. 1329 NORTH SEA RD, GRANDFATHER APPLICATION SOUTHAMPTON N. Y. 11968 516-283-6360 1. Name of Applicant: Marilyn Morsch by En-Consultants, Inc. 2. Mailing address: P.O. Box 358, 420 Schooner Dr. Southold, NY 11971 Tel. No: (516) 765-1349 3. Address of Property: 420 Schooner Dr. Southotd, NY 11971 4. Tax Map Number: 1000-71-2-9 Approx.yr.of construct: 1965 5. Prior owner if known: 6. Diagram 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 pyners,_ etc. Signature of applicant: Roy L. ~e, Presi~nt Date: July 13, 1992 * Please note, there is a one time fee of $50.00 for filing this application.