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JUDITH T. TERRYt~ Town Hall, 53095 Main Road
TOWN CLERK : o r= P.O. Box 1179
.� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS t. Fax (516) 765-1823
MARRIAGE OFFICER =_'`O �% ) �� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER ••
FREEDOM OF INFORMATION OFFICER �� iii,i,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 50 N Residential Non-Residential X
Fee $ 25.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : GARY TABOR
Address 1 : 680 NAVY STREET
City St Zip ORIENT NY 11944
Descripton of Proposed Construction or Alteration
INSTALLATION OF 8 X8 LEACHING POOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, AND PROPERTY LINES,ETC. PROVIDE COVERS AS REQUIRED BY SCHD
FOR SYSTEMS IN DRIVEWAYS 8 PARKING AREAS. EXCAVATION INSPECTION NEEDED
Name Of Owner RIVERHEAD LUMBER
Mailing Address 1 MAIN ROAD
City St Zip GREENPORT NY 11944
Property Address 1 MAIN ROAD
City St Zip GREENPORT NY 11944
Tax Map No. section 46.00 block 1 lot 1 .000
Cross Street MOOR ES LANE
Building Permit Number Cross Reference:
Issue Date: 6/24/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY : Z .G . Town Hall, 53095 Main Road
TOWN CLERK ` p r= P.O. Box 1179
tri W : Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �,YO �. ,' Fax (516) 765-1823
MARRIAGE OFFICER '":-......7491'' �O ,., Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER 4 •
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FREEDOM OF INFORMATION OFFICER ''���.�iiiiririr
OFFICE OF THE TOWN CLERK 1 R u : F1
TOWN OF SOUTHOLD
j JUN 6 Ng
TO: Southold Town Building Department "_
FROM: Linda Cooper, Southold Town Clerk's Office Q ,. �:T.
DATED: June 15, 1994
Transmitted herewith is a copy of application No. A1193 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Gary Tabor for Riverhead Lumber .
Please review the application and location map and advise if this office may
issue the permit.
Please complete the form below and return it to this office.
Thank you.
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE -
DISAPPROVE - EXCAVAT N NISPECTION
COMMENTS: MIMED
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/,75-,a-in Signatur
JUN 24 1994 9
town Clerk Southold D a t
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OFFICE OF THE TOWN CLERK OS�FFOL(eO
Town of Southold
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Judith T. Terry, Town Clerk ' Application No. I !Q 3
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 0 O� Alteration
Telephone -rjr"1 t ' ` Residential
(516) 765-1801
Non-Residential
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TOWN OF SOUTHOLD
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SOUTHOLD WASTEWATER DISPOSAL DIS RICT
APPLICATION , ,
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for
I,r CONSTRUCTION or ALTERATION PERMIT
SEPTIC TAIL( or CESSPOOL
,,i Permit No.
Fee $
DATE / , y 99/
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APPLICANT NAME: ())" y 72.42- -e0)---,
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APPLICANT ADDRESS: , _/0. 0 v/ .
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SEPTIC CESSPOOL 2/
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
T. —7" y.S %1 /1 5 >c. r 1/' C-,9 c�1 ) i A--,/,92 , •
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTIONR ALTS ATION:
OWNER OF PROPERTY: )7) I V j-A .C,b d -1 v i
OWNER MAILING ADDRESS: 5. r C f "or i
OWNER PROPERTY ADDRESS: S152- . -C_____
TELEPHONE NUMBER OF CONTACT PERSON: 32- 3- ,? 7
TAX MAP NO. : Section Yb Block J Lot 1
CROSS STREET : 1// P a /"e_ ,S ) -v' e..--
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BUILDING PERMIT NUMBER CROSS REFERENCE:
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Si ure of Applicant
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RECEIVED BY:
Town Clerk's Office
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