HomeMy WebLinkAboutBreuer, Peter t 'oFFOui--o
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JUDITH T.TERRY ; Town Hall, 53095 Main Road
TOWN CLERK H Z P.O.Box 1179
REGISTRAR OF VITAL STATISTICS Southold,New York 11971
MARRIAGE OFFICER \1 °� Fax Fax(516)765-1823
RECORDS MANAGEMENT OFFICER q `1►����� Fax
(516)765-1800
FREEDOM OF INFORMATION OFFICERI"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1326 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL SERVICE
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW CESSPOOL 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 BREUER, PETER C.
Mailing Address 1 BOX 266
City St Zip EAST MARION NY 11939
Property Address 1 37 DOGWOOD LANE
(355 BAYVIEW DRIVE)
City St Zip EAST MARION NY 11939
Tax Map No. section 37.00 block 1 lot 7.000
Cross Street DOGWOOD LANE
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 : •V14. Town Hall, 53095 Main Road
TOWN CLERK =o P.O. Box 1179
N Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = VO �. Fax (516) 765-1823
MARRIAGE OFFICER ��//�� �O ,�' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER m/,/ 4
FREEDOM OF INFORMATION OFFICER = ,,,,,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
APR 2 8 1995
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: April 28, 1995
Transmitted herewith is a copy of application No. A1375 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Breuer
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.
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Date
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OFFICE OF THE TOWN CLERK """
Town of Southold •" 0FULk
Judith T. Terry, Town Clerk
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Application No. /�7�
Town Hall, 53095 Main Road �L ; Construction ✓
P. 0. Box 1179 Alteration
Southold, New York 11971 ',to *',`
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Telephone -.4 *V $10.00 - Residential
(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 gge di ( '' ''ir
(i . , 'z7(APPLICANT NAME:
APPLICANT ADDRESS: 276'0 .0/C.
. JIV*7'';°-
SEPTIC CESSPOO
DESCRIPTION OF PROPOSED CONSTRUCT1e N OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
i1 �
OWNER OF PROPERTY: 't'2.'�-L2,G. 46„ / Ab•
u
OWNER MAI 1NG ADDRESS: 3 7 p 1^a- 0 o Vok
(35i- diNarw toy
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 7hT �,7
TAX MAP NO. : Section 3 7 Block 7 Lot_
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
9/17/4 "
Signature of Applicant
RECEIVED BY: W,C.-Q��
/o;,r_n Clerk's Office
DATE: v4
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OZICI C641172
30
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