HomeMy WebLinkAboutShannon, Mary Lee 1 1, "..
JUDITH T.TERRY ?�= y1 Town Hall, 53095 Main Road
TOWN CLERK i y = $ P.O. Box 1179
7 t Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER '4 0� iI°% Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER v.( * •' Tel
` of' (516) 765-1800
FREEDOM OF INFORMATION OFFICER „„ ,i0"�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1469 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
INSTALL 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 SHANAHAN, MARY LEE
Mailing Address 1 130 PINEHURST TERRACE
City St Zip PINEHURST NC 28374
Property Address 1 VILLAGE LANE
City St Zip ORIENT NY 11957
Tax Map No. section 25.00 block 3 lot 8.000
Cross Street FLETCHER STREET
Building Permit Number Cross Reference:
Issue Date: 4/30/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY � � y!� Town Hall, 53095 Main Road
TOWN CLERK ti i P.O. Box 1179
rft � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER L 4* �� �1� Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER ‘i 49l -0„10 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: April 25, 1996
Transmitted herewith is a copy of application No. .-1 /5l9 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Gary Tabor for Mary Lee Shanahan
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 - L�
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
RECEIVED
APR 2 9 1996 Signa . r
Town Clerk Southold Date ! Fes,
OFFICE OF THE TOWN CLERK ""
Town of Southold �FF11K
Judith T. Terry, Town Clerk �� Application No.
Town Hall, 53095 Main Road ;G Construction
P. 0. Box 1179 Alteration
Southold, New York 11971
Telephone ‘740 � � $10.00 - Residential
(516) 765-1801 1 ,, $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 ///21./ /? 0,
APPLICANT NAME: 6 R ti J f9 ' 01'
APPLICANT ADDRESS: b 5O 1-✓A v y S
ti
SEPTIC
SEPTIC CESSPOOL 1/-
DESCRIPTION
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
S
j / -e/9G %, /
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /27/1;2t/ / 6 3',.1=1 A6V-41.44A/
OWNER MAILING ADDRESS: / 30 ��'�c� , / eft
i 71`•
OWNER PROPERTY ADDRESS:
'// 1 e AV/42#-7/'e._ 6
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section/400 Block 2 5 Lot 03-0 r
CROSS STREET: /-/c �? �� S �r �� /
BUILDING PERMIT NUMBER CROSS REFERENCE:
=ire of Applicant
RECEIVED BY:
TowRIEGIMPVIWice
DATE: APR 2 5 1996
Ton Clerk Soithold
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