HomeMy WebLinkAboutNemschick, Richard ofFour --
JUDITH T.TERRY t y< Town Hall, 53095 Main Road
TOWN CLERK , ti i P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O T $ Southold, New York 11971
MARRIAGE OFFICER :�y �1�, Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER 491 1ZGil Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER --••••.. o
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1504 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : NEMSCHICK, RICHARD
Address 1 : AUER, SUZANNE
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR A NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-96-0041
Name Of Owner NEMSCHICK, RICHARD
Mailing Address 1 AUER, SUZANNE
P. O. BOX 1332
City St Zip MATTITUCK NY 11952
Property Address 1 1035 SEBASTIAN COVE ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 100.00 block 3 lot 11 .014
Cross Street MILL ROAD
Building Permit Number Cross Reference:
Issue Date: 6/28/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY � Gy1�, Town Hall, 53095 Main Road
TOWN CLERK ` N P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
v. 47/
,�� Southold, New York 11971
MARRIAGE OFFICER : yijJ �� / Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER 1igg 'j •,f� Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER "�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 27, 1996
Transmitted herewith is a copy of application No. 1569 for a Cesspool/
Septic Tank Construction Permit submitted by:
Richard Memschick/Suzanne Auer •
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me. � � ""----�--
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Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE cl
Comments: e of P y►-� c �, e ® —.9 • e
Signatur
Date
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OFFICE OF THE TOWN CLERK �•�. " •
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Town of Southold ' \ f01��'
Judith T. Terry, Town Clerk �;, sOGyi Application No/. 7 Hall, 53095 Main Road ; � • Construction L'
P. 0. Box 1179 o rn ;
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