HomeMy WebLinkAboutLuscher, Charles ,„,,. ..��
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ELIZABETH A.NEVILLE ti <i$ Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
y yc Southold, New York 11971
MARRIAGE OFFICER ► b$.O /�, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER r� Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER `I(COON% rr
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3333 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : CHARLES LUSCHER
Address 1: 820 BAYVIEW DRIVE
City St Zip EAST MARION NY 11939
Descripton of Proposed Construction or Alteration
3LTERATION/ADDITION TO EXISTING SYSTEM.
AWPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner LUSCHER, CHARLES
Mailing Address 1 820 BAYVIEW DRIVE
City St Zip EAST MARION NY 11939
Property Address 1 820 BAYVIEW DRIVE
City St Zip EAST MARION NY 11939
Tax Map No. section 37.00 block 5 lot 6.000
Cross Street ORCHARD LANE
Building Permit Number Cross Reference:
:.-slue Date: 7/08/05 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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3333 I
aaF:SouTy 3333
ELIZABETH A. NEVILLE � p Town Hall, 53095 Main Road
TOWN CLERK * 4g ; P.O. Box 1179
Ith:CIS'I'KAK OF VITAL STATISTICS
«, Southold, New York 11971
MARRIAGE OFFICER �. � �O Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER c/. v\ Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER cC11N;�I.N<c. southoldtown.northfork.net
OFFICE OF THE TOWN CLERK •
TOWN OF SOUTHOLD
TO: Southold Town Building Department LJUi
' 642577
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FROM: Linda J. Cooper, Southold Town Clerk's Office 8 „o,,,,.-Epr
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DATED: June 6, 2005
Transmitted herewith is a copy of application No. 3476 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Charles Luscher
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
Linda J. Cooper
* * * * * * * * * * * _ *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
•
APPROVE
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells, buildings, property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
•
•
Signature
7 oero S—
ted
OFFICt OF THE TOWN CLERK ,,,, ,,,,."'--
Town of Southold ,�' �FF°Ir
Judith T. Terry, Town Clerk � C�l/y Application No.
Town Hall, 53095 Main Road itzr Construction
P. O. Box 1179 m •
Southold, New York 11971 , Alteration
Tele hone = ��' $10.00 - Residential
p :'1,g►D .�`a�,
(516) 765-1801 1 ,, $25.00 - Non-Residential
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE U
APPLICANT NAME: C�c%/2/A"T^ 4., �PG--
APPLICANT ADDRESS: 4y f1/
/ ,79
SEPTIC CESSPOOL✓
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
b J %/a// /geed/, c4 7 notes a
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY :
OWNER MAILING ADDRESS: � 2p di'
OWNER PROPERTY ADDRESS: -51/-1-7 ,f
TELEPHONE NUMBER OF CONTACT PERSON: (—! I1�ZZ—
TAX MAP NO. : Section �j Block 3 Lot
CROSS STREET: ®/0.j
BUILDING PERMIT NUMBER CROSS REFERENCE:
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ignatu e of pp cant
RECEIVED B :
Town Clerk's Office
DATE: • 0
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