HomeMy WebLinkAboutBaumgratz, Richard ' + ej FOL j'
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JUDITH T.TERRY = Town Hall,53095 Main Road
TOWN CLERK t/, x ; P.O.Box 1179
'r0 • Southold,New York 11971
REGISTRAR OF VITAL STATISTICS �` 1, �1 Fax(516)765-1823
MARRIAGE OFFICER > 4$ a°���� Telephone(516) 00
RECORDS MANAGEMENT OFFICER 1 1//
FREEDOM OF INFORMATION OFFICER '������ ,••�/
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1301 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL SERVICE
Address 1 : 2765 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW 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 BAUMGRATZ, RICHARD
Mailing Address 1 143 MEADBROOK ROAD
City St Zip GARDEN CITY NY 11530
Property Address 1 1565 SMITH DRIVE S
City St Zip SOUTHOLD NY 11971
Tax Map No. section 76.00 block 2 lot 37.003
Cross Street BAYV I EW ROAD
Building Permit Number Cross Reference:
Issue Date: 3/23/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY ` o :4 ‘ Town Hall,53095 Main Road
TOWN CLERK k ds Z , P.O.Box 1179
0 0 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS / Fax(516)765-1823
MARRIAGE OFFICER y� O�11
RECORDS MANAGEMENT OFFICER 01 `1►a,111 Telephone(516)765 1800
FREEDOM OF INFORMATION OFFICER �.�., ,i-a1
I 1r*MT EIIUC k '
OFFICE OF THE TOWN CLERK '
TOWN OF SOUTHOLD
TO: Southold Town Building Department ^6; VP
l
FROM: Linda Cooper, Southold Town Clerk's Office •-yy�,,`—�;--•--• i
DATED: March 17, 1995
Transmitted herewith is a copy of application No. A1348 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
BeLA. ✓r' 6e6 -T- -z__
Morris Cesspool for Richard Braumgratz .
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. ,Q
i '4, ec u
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.
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Date
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OfilICE OF THE TOWN CLERK "",,,,, .
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Town of Southold 0 = �
Application No.
Judith. T. Terry, Town Clerk .1pp
Town Hall, 53095 Main Road :4.1_ Construction I
P. O. Box 1179 :: 0 f •
Southold, New York 11971 Alteration --7:.,
`; �' " $10.00 - Residential v
Telephonet�
(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- e,,4,., ,, ,/ i'---/
APPLICANT NAME: .7Sv,�r r ..th ,
APPLICANT ADDRESS: 256 ->(
SEPTIC CESSPOOL- /
DESCRIPTION OF PRO SED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUC ION OR ALTERATION:
OWNER OF PROPERTY-/'_i ,/ 'j j(” 4174
OWNER MAILING ADDRESS: / ,SWIM . ' S
5jc .0)
OWNER PROPERTY ADDRESS: /Gf,3 /c,¢J
TELEPHONE NUMBER OF CONTACT PERSON: 7‘.5.-7--,,,F -6TAX MAP NO. : Section 7‘ Block Lot _05
CROSS STREET: "B ,v Rd
BUILDING PERMIT NUMBER CROS REFERENCE:
97, V9 / , .
C Signature o Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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