HomeMy WebLinkAboutSchultz, William I ULIr0D",l
g i Town Hall, 53095 Main Road
`0<tt
`. P.O. Box 1179
.�1D� Southold, New York 11971
JUDITH T.TERRY TELEPHONE
.
TOWN CLERK %����� ._
(516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1586 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF CESSPOOL 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 SCHULTZ, WILLIAM
Mailing Address 1 200 WASHINGTON AVENUE
City St Zip GREENPORT NY 11944
Property Address 1 200 WASHINGTON AVENUE
City St Zip GREENPORT NY 11944
Tax Map No. section 41 .00 block 1 lot 41 .000
Cross Street MAIN STREET
Building Permit Number Cross Reference:
Issue Date: 12/20/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
�SUFFO(,-
c /5--(f /
JUDITH T.TERRY � ?1Town Hall, 53095 Main Road
TOWN CLERK y = P.O. Box 1179
REGISTRAR OF VITAL STATISTICS $ Southold, New York 11971
MARRIAGE OFFICER / Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER 0? lig *--„,01 Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ,•���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department DEC 8
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: December 18, 1996
Transmitted herewith is a copy of application No. 1654 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for William Schultz •
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.
cc.
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.
RECEIVED
DEC 20 1986 ignat re
/;oP
Southold Town Cerk Dat
• 4 •
OFFICE OF THE TOWN CLERK ,s -
Town of Southold 4'' �FFDl�t'
Town Clerk � a Application No. /6 J
Judith T. Terry,
Town Hall, 53095 Main Road Z ;L ; Construction
P. O. Box 1179 /j
Southold, New York 11971 • ;; Alteration
Telephone A, .&s. $10.00 - Residential
(516) 765-1801 •- '1 4 y,, $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 (( /t
APPLICANT NAME: / • ��/:�
APPLICANT ADDRESS: 2766
SEPTIC CESSPOOL'\)
DESCRIPTION ', PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION •R ALTERATION:
OWNER OF PROPERTY: , //
OWNER MAILING ADDRESS: 4).- Ze /40-q-
-
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 2(--5--- ,53e-6
TAX MAP NO. : Section L// Block l Lot //
CROSS STREET : //A 'P
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: /14l
Town Clerk's Atte-
DATE: o�/� t-/94 -�
Gi' /�rss
.F
0
6.;\ v
71,66,) (•/
/1-)
30 7:--,
g
6 •iiiii
S