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Home My WebLink AboutWhitehead, Norman Town Hall 53095 Main Road I�1;�� ; P.O. Box 1179 '/ �0 ' Southold, New York 11971 JUDITH T.TERRY 11,1,.�1 - TELEPHONE TOWN CLERK "116106TELEPHONE (516) 765-1801 REGISTRAR 01 VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1580 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : GARY TABOR Address 1 : 680 NAVY STREET City St Zip ORIENT NY 11952 Descripton of Proposed Construction or Alteration INSTALL 900 GALLON SEPTIC AND 8' X 12' POOL TO EXISTING SYSTEM. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS BUILDINGS, PROPERTY LINES, AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. Name Of Owner WHITEHEAD, NORMAN Mailing Address 1 14909 MAIN ROAD City St Zip EAST MARION NY 11939 Property Address 1 14909 MAIN ROAD City St Zip EAST MARION NY 11939 Tax Map No. section 23.00 block 1 lot 2.003 Cross Street Building Permit Number Cross Reference: Issue Date: 12/17/96 Judith T. Terry Southold Town Clerk (TOWN SEAL) • • O� OGS JUDITH T.TERRY �is_� �� Town Hall, 53095 Main Road TOWN CLERK % y i % P.O. Box 1179 REGISTRAR OF VITAL STATISTICS I` Southold, New York 11971 MARRIAGE OFFICER .. y ��111' Fax (516) 765-1823 RECORDS MANAGEMENT OFFICER ;�0? ilig *� 11 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 J c DATED: December 11 , 1996 Transmitted herewith is a copy of application No. 1648 for an ALTERATION PERMIT for a cesspool or septic system submitted by Gary Tabor for Norman Whitehead . 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 reco mendation: APPROVE - DISAPPROVE - COMMENTS: Maintain required setbacks from adjacent wells, buildings, property lines and water bodies. EXCAVATION INSPECTION REQUIRED. RECEIVED -.-IV /, s`' _ Signature DEC 171996 / - 3 ,i Date / ' Southold Town Clerk OFFICE OF THE TOWN CLERK ��,,''' �Ol Town of Southold st xi C Judith Te Terry, Town Clerk ,��'�� l/ Application No. /� ' Town Hall, 53095 Main Road Z Construction •P. O. Box 1179 o z„ � Southold, New York 11971 �tj'� ��; Alteration y - Residential Telephone O �� $10.00 (516) 765-1801 .1 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 d ! /7 �‘ APPLICANT NAME: e--79-1/1 '77 ///94O/Th APPLICANT ADDRESS: /, O j/ 'cam" 7 SEPTIC V✓CESSPOOL (/ DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION 1 5 7�7/ 70 -`¢) .--r j, `cJ / too /. LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION : OWNER OF PROPERTY: "7/0t)/k11 /--/. LAJibircAeAd OWNER MAILING ADDRESS: ) 1/ 9U `7,,'97 ,/?2 OWNER PROPERTY ADDRESS: 5 6 c -- TELEPHONE NUMBER OF CONTACT PERSON: 13 `�L ^",jjfj TAX MAP NO. : Section 'Q1' 3 Block © / Lot 2-, ..I CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: V'3 7 Gnure of Applicant RECEIVED BY: Aii /9/.4.2.-7.1_,Q__ Town Clerk's Office DATE: / // cric774. ..- ------i � �� / fie- �1 fu2r -H-0o5 � - i (Ai• r .\ '6"�.