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Instructions

Please submit this form using any of the contact methods provided below.

Instructions
Provider Name
Town of Shelter Island, NY
Provider Mailing Address
Attn: Town Clerk
P. O. Box 1549, 38 North Ferry Road
Shelter Island, NY 11964-1549
Provider Phone
631-749-1166
Provider FAX
631-749-3436
Provider Email
townclerk@shelterislandtown.gov

Application

Permit Number
IYKKXUHD
Application Status
Unknown
Application Phase
Other Public Access
Application Type
Congdon's Creek Dock
Application Sticker Number

Applicant

Mobile Phone
First Name
Middle Name
Last Name
Contact Information
Mailing Street
Mailing City
Mailing State
Mailing Zip
Use Same Address Below
Local Street Number
Local Street Name
Local City
Local State
Local Zip Code
Home Phone
Email Address

Attachments

Acceptance

Terms and Conditions


I have read and understand the Online Mooring User Terms and Conditions
Signature
Date