HomeMy WebLinkAboutJohnston, George OG/' O•'
JUDITH T.TERRY l,� yt• Town Hall, 53095 Main Road
TOWN CLERK ; y i •• P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS % 0
MARRIAGE OFFICER :�'jjf� 0�111 Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER l �a��11 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1513 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : GEORGE JOHNSTON
Address 1 : 85 MESROBIAN DRIVE
City St Zip LAUREL NY 11948
Descripton of Proposed Construction or Alteration
REPLACE EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES, AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner JOHNSTON, GEORGE
Mailing Address 1 P. O. BOX 416
City St Zip LAUREL NY 11948
Property Address 1 85 MESROBIAN DRIVE
City St Zip LAUREL NY 11948
Tax Map No. section 145.00 block 4 lot 6.000
Cross Street PECONIC BAY BLVD.
Building Permit Number Cross Reference:
Issue Date: 8/06/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
1 ,,'iii.--
10
ill Of Folat
1, �O
JUDITH T.TERRY tt y< Town Hall, 53095 Main Road
TOWN CLERK y 2 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ` O
Southold, New York 11971
MARRIAGE OFFICER . 4' �1�/ Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER . °l *.00° Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER •...., ,,"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department :_ x
LLL,
FROM: Linda Cooper, Southold Town Clerk's Office TOWN
: July 24, 1996
Transmitted herewith is a copy of application No. 1578 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
George Johnston (work by Ray Nine)
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.
Sign:tur:
Dat
p73
OFFICE OF THE TOWN CLERK ,,,,,, ,, -
Town of Southold Application Nos �o
Judith T. Terry, Town Clerk 4`''
Town Hall, 53095 Main Road ;L ; Construction
P. O. Box 1179 o
Alteration
Southold, New York 11971
Telephone 'a0 $10.00 - Residential
(516) 765-1801 Ol 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
APPLICANT NAME: igeib
vANs /off
APPLICANT ADDRESS:
4-e-,
SEPTIC " CESSPOOL—I
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/ee-j°4-jC - /6- K/S(/ __7)T
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRU TION OR ALTERATION:/
OWNER OF PROPERTY: =U e \) A
Q OWNER MAILING ADDRESS: FZ-) 6r /6
o _ ( r w //9'' t
OWNER PROPERTY ADDRESS: � -
TELEPHONE NUMBER OF CONTACT PERSON:,..V/6 "
TAX MAP NO. : Section /LIT- Block 6i Lot C/ (p
CROSS STREET : ),GerY/C _ re £t U)
BUILDING PERMIT NUMBER CROSS REFERENCE:
11111
S' of Applicant
RECEIVED BY :k,
T•wn Clerk's Office
DATE:
1 ^ R a
11.
;
utftrtr roar i 1
-� ' '�'' ANS;
•N .
"Kr. 40,...T., vgimi, 09
vtkN
t.,,i,.... 0.0 S "r► ,; t`
C • �' .t; ���`
{ CO*. 0.414,
I
- --- ��4-'4. , ���
• 4
h
i
CI) til I
•
1441'k°
(„�u� •
1, _ p IltM6NT ,5117,9e a { ,}il! ^ � '.
1' � srrrcrb pk1 1 litil0� _10,1,44 ' by ( "VV7O tj31' :'
Ira • 0
t` , 0 r )
comaii ,
EN il
t�
�,h0 N toot:- ,,, PA t r : .
0.1.. Ni FNn it. " � _ .. ... r .y 'J
\\ 4 0•Ir f Virg 41 /17'v /Q �I✓ f �'
193.26'' 3 ^ � 1
irilk.
PV 4
r‘k'
f
4'