HomeMy WebLinkAboutBarker, Robert ELIZABETH A.NEVILLE $h`Z` `'Gyms�` Town Hall, 53095 Main Road
TOWN CLERK ; p - P.O. Box 1179
y 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ' . Fax (516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER : �0 %\'�1�1 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER .
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1850 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : RAYMOND F. NINE
Address 1 : 855 NEW SUFFOLK AVENUE
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
REPLACE EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner BARKER, ROBERT
Mailing Address 1 3775 NEW SUFFOLK AVENUE
City St Zip MATTITUCK NY 11952
Property Address 1 3775 NEW SUFFOLK AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 115.00 block 3 lot 27.000
Cross Street MARRATOOKA ROAD
Building Permit Number Cross Reference:
Issue Date: 4/29/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE ,``1 Gy Town Hall, 53095 Main Road
TOWN CLERK c 1 P.O. Box 1179
y 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 0iv,'�� Fax (516) 765-1823
MARRIAGE OFFICER � y
RECORDS MANAGEMENT OFFICER , Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: April 24, 1998
Transmitted herewith is a copy of application No. 1924 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Raymond Nine for Robert Barker
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 -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
S' nature
Date
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OFFICE OF THE TOWN CLERK ,,• ��f
TOWN OF SOUTHOLD �� �J Application No. / 9 2
ELIZABETH A.NEVII LF,TOWN CLERK
P.O.BOX 1179 4. Construction
SOUTHOLD,NEW YORK 11971
Alteration
Telephone ,I ft" $10.00 - Residential
(516) 765-1801 _4
,,•' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE A/2 /V
APPLICANT NAME: _ ,'/1 y h o m, f, Ili/ 11/.5
APPLICANT ADDRESS: ,'j/E(,f falx VF
j577 1T G )1 75-2--
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: If a BE4T / 49)'i ;e
OWNER MAILING ADDRESS: 3 Ms /7/ 1i1 s >4- /F jam'
M ,17 T17 //4/(- )y j/9s-z
OWNER PROPERTY ADDRESS: S A AA---E_
TELEPHONE NUMBER OF CONTACT PERSON: 27
TAX MAP NO. : Section //5 Block 3 Lot 27
CROSS STREET: liReyq]'OG1C fa 11)9
BUILDING PERMIT NUMBER CROSS REFERENCE:
/g r
i• ature'of Ap lcntI' aler
RECEIVED BY: Ll12X/
ow� Clerk's�Office
5/DATE: 7
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