HomeMy WebLinkAboutSickler, Marianne e" —
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JUDITH T.TERRY t•41/4*� Town Hall, 53095 Main Road
TOWN CLERK N Z P.O. Box 1179
t Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ‘1.1.3
MARRIAGE OFFICERA •���' Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER Od `1►a �� Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER '—.., ',,I�,�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1557 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : CARY TABOR
Address 1 : 680 NAVY STREET
City St Zip ORIENT NY 11957
Descripton of Proposed Construction or Alteration
ADDITION OF A NEW 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 SICKLER, MARIANNE
Mailing Address 1 200 BREITSTADT COURT
City St Zip SOUTHOLD NY 11971
Property Address 1 200 BREITSTADT COURT
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 9 lot 28.000
Cross Street CUSTER AVENUE
Building Permit Number Cross Reference:
Issue Date: 10/24/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY ���� yj Town Hall, 53095 Main Road
TOWN CLERK y i P.O. Box 1179
REGISTRAR.OF VITAL STATISTICS O
" 7 � Southold, New York 11971
MARRIAGE OFFICER � � �1 Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER �l * �a„11. Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER so
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department - 9
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: October 8, 1996
Transmitted herewith is a copy of application No. 1623 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Gary Tabor for Marianne Sickler
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.
RECEIVED
OCT 14 1996 Signa' e
Southold Town CidDa
te
OFFICE OF THE TOWN CLERK
----4,_, % Town of Southold ;,''"stfDUr Application No. /623
*5 Judith T. Terry, Town Clerk ►
41.
.
,', Town Hall, 53095 Main Road ; Construction
ft:-Vr
P. 0. Box 1179
v X i Alteration
Southold, New York 11971 N 4,-... ,*'$
Telephone O ��,,', $10.00 -Residential
_ ' (516) 765-1801 _ _t * , 7' $25.00 -Non-Residential
_____f TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
'a I CONSTRUCTION or ALTERATION PERMIT
.__ "' SEPTIC TANK or CESSPOOL
{k ,K
7 Permit No.
Fee $
w .
DATE /O/ r.19 et
APPLICANT NAME: , /, y J/a-60/--'
APPLICANT ADDRESS: 6 O ji U 7' S l
SEPTIC CESSPOOL
., DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
.' fi _7ri/5 i , J/ 5--x l ke..9ct,A/ 'w9 ,c)c, J.
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
k OWNER OF PROPERTY: //yA2f1,'fq /70?/� 3.-/ 'eirjj r'
OWNER MAILING ADDRESS: per?co ,(3,' e,' S gTi¢a/7,
iS ,
OWNER PROPERTY ADDRESS: 5 Az -L
TELEPHONE NUMBER OF CONTACT PERSON: ,j 23-- . ,i$ '2
TAX MAP NO.: Section 7 0 Block 9'• Lot Sr-
CROSS STREET: C U 5 l-6t- f(/
t,44
* :; BUILDING PERMIT NUMBER CROSS REFERENCE:
_ ;14' yg,,,,,
' atur
Sof Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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