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JUDITH T.TERRY ��_ mac Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
rrt1,i Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER � ��� Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER �: � jag � � 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. 1479 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : GARY TABOR
Address 1 : 680 NAVY STREET
City St Zip ORIENT NY 11957
Descripton of Proposed Construction or Alteration
INSTALLATION OF A 4' X 8' LEACHING POOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION
INSPECTION REQUIRED.
Name Of Owner REINHARDT, ELLA
Mailing Address 1 2555 REYDON DRIVE
City St Zip SOUTHOLD NY 11971
Property Address 1 2555 REYDON DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 80.00 block 5 lot 8.001
Cross Street WEST SHORE DRIVE
Building Permit Number Cross Reference:
Issue Date: 5/16/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•
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JUDITH T.TERRY ��= yL Town Hall, 53095 Main Road
TOWN CLERK ; ti Z P.O. Box 1179
Zr 1 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS : O � � Fax (516) 765-1823
MARRIAGE OFFICER 4f� �`jos°,� Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER 1 4[
FREEDOM OF INFORMATION OFFICER•
OFFICE OF THE TOWN CLERK i;
TOWN OF SOUTHOLD MAY — 7 P .
TO: Southold Town Building Department
BLDG.OEM
FROM: Linda Cooper, Southold Town Clerk's Office T• •. i"L`--'
DATED: May 6, 1996
Transmitted herewith is a copy of application No. A1540 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Gary Tabor for Ella Reinhardt
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.
Th
ignatur-
Date
aPPI•eE OF THE TOWN CLERK ""
Town of Southold `rj'��
Judith T. Terry, Town Clerk � -' Application No.
Town Hall, 53095 Main Road .4. ; Construction
P. O. Box 1179
Southold, New York 11971 ,� Alteration
Telephone - j ���' $10.00 - Residential
(516) 765-1801 -j 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: /��' //57 ICJ—
APPLICANT ADDRESS: Za
/C ter/
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION R ALTERATION
•
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTER TION:
OWNER OF PROPERTY: /C:-/_/" /re // / d
OWNER MAILING ADDRESS: �5 .` _ep ,e-c„/
Sc C.) 7*o/O!
OWNER PROPERTY ADDRESS: S vyt_--r
TELEPHONE NUMBER OF CONTACT PERSON: 3 „
TAX MAP NO. : Section 9O Block S Lot
CROSS STREET: wes't1Aor •�v ,
BUILDING PERMIT NUMBER CROSS REFERENCE:
ignature of Applicant
RECEIVED BYE` � 1
Town TCI ' . ' • fice
DATE: (...SY /9'64'
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