HomeMy WebLinkAboutAlbertson, Lester JUDITH T.TERRY ; 4 Town Hall,53095 Main Road
TOWN CLERK en Z ; P.O.Box 1179
• 0.0 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER \ Fax(516)765-1823
'n al1 Fax
(516)765-1800
RECORDS MANAGEMENT OFFICER 1 ��
FREEDOM OF INFORMATION OFFICER , ••4
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1328 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
ADDITION OF AN 8 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 ALBERTSON, LESTER
Mailing Address 1 56125 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 56125 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 63.00 block 3 lot 10.000
Cross Street BOISSEAU AVENUE
Building Permit Number Cross Reference:
Issue Date: 5/04/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY : , yL ; Town Hall, 53095 Main Road
TOWN CLERK : o rzi+ P.O. Box 1179
tp � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS VO �� Fax (516) 765-1823
MARRIAGE OFFICER �j �� ��� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER — �'K/,` •�
FREEDOM OF INFORMATION OFFICER ' ,�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
MY
TO: Southold Town Building Department 21,94,E
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: May 2, 1995
Transmitted herewith is a copy of application No. A1377 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Gary Tabor for Lester Albertson
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.
L�J irri‘.�
Signatur-
Date
ti
1
OFFICE OF THE TOWN CLERK ,<<'"", �/
Town of Southold UFFD�K = 3 y
Judith T. Terry, Town Clerk �� Application No.
Town Hall, 53095 Main Road Construction
P. O. Box 1179 v m ; Alteration
Southold, New York 11971 ;tn �;
Telephone
$10.00 - Residential
(516) 765-1801 .w�Ol � , $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 ;� //
APPLICANT NAME: r / 1 . 4/'
APPLICANT ADDRESS: (.0 8"-C7 J1/ L-')/ 5 l
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SEPTIC CESSPOOL V
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ,-e ,s %e i' ,/Q /'► rs
OWNER MAILING ADDRESS: 57,) �I/�" / ,1'� ls'1; '/,1 /r
S r9 U TA d l ci
OWNER PROPERTY ADDRESS: S x}
TELEPHONE NUMBER OF CONTACT PERSON: - 2 5 - Cv 7
TAX MAP NO. : Section ,Li 3 Block 3 Lot ) d
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Si ture of Applicant
RECEIVED BY:
Town er 's Office
DATE: MAY 2 1995
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