Loading...
HomeMy WebLinkAboutDowling, Claire I OF Mit O G ' JUDITH T.TERRY ��_ yet Town Hall, 53095 Main Road TOWN CLERK ; 0,,, #0 etf F04 / 7?-' JUDITH T.TERRY � y<`� Town Hall, 53095 Main Road TOWN CLERK ; y P.O. Box 1179 REGISTRAR OF VITAL STATISTICS ‘14' 'y �4 MARRIAGE OFFICER (� �I��,� Southold,New York 11971 Fax(516) 765-1823 RECORDS MANAGEMENT OFFICER : 49./ `�►*el Telephone(516) 765-1800 FREEDOM OF INFORMATION OFFICER ••v„.. ,•�� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda Cooper, Southold Town Clerk's Office DATED: November 15, 1996 Transmitted herewith is a copy of application No. A1640 for an ALTERATION PERMIT for a cesspool or septic system submitted by Gary Tabor for Claire Dowling 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. RECE '' Signature 0NI 2 51996 Date �� 3 o etc SouthotdT OFFICE O; TH' TOWN CLERK ,'" ' Town of Southold grUar i Judith T. Terry, Town Cler Cp Application No./ Town Hall, 53095 Main R Construction P. 0. Box 1179 •r ; o ,mart c Southold, New York 11971 `0 �; Alteration Telephone ,j,,0 1��01�' $10.00 - Residential /9 (516) 765-180k' : 1 , " $25.00 - Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICAT ION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE ) / / / 7 /96 APPLICANT NAME: yO/ APPLICANT ADDRESS: / �© J7/, 2 / / S /_ 1T ' I SEPTIC CESSPOOL L- DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION - G / s / / O .s LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONST /! IAAlsiby,_TEID' f t 44/0,� OWNER F PROPERTY: " R:74-7-=-/-"-!-Ar-AA:"" GL/G OWNER MAILING ADDRESS: )O S 75 SA,;e0 /0,1>i /419 s T U'-1/4/ OWNER PROPERTY ADDRESS: 5/-9•"--0-z TELEPHONE NUMBER OF CONTACT PERSON: 3 3- 7o /7 TAX MAP NO. : Section 3 Block ) Lot `/ CROSS STREET: POJ e BUILDING PERMIT NUMBER CROSS REFERENCE: Gam" I 5' ature of Applicant RECEIVED BY: /- , / Town Clerk's fice DATE: ' / // ,_5 796 f _ yi 1/ ro ego / //c, os 5_.4ff