HomeMy WebLinkAboutBurkhardt, William O11
JUDITH T. TERRY .G ; Town Hall, 53095 Main Road
z ; P.O. Box 1179
TOWN CLERK Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ;VO . ; Fax (516) 765-1823
MARRIAGE OFFICER = Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER • �
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. 1246 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : TONY POSILLICO
Address 1 : 31 TENNYSON AVENUE
City St Zip WESTBURY NY 11590
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-94-0091
Name Of Owner BURKHARDT, WILLIAM
Mailing Address 1 5532 BAYVIEW ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 WABASSO STREET
City St Zip SOUTHOLD NY 11971
Tax Map No. section 78.00 block 3 lot 44.001
Cross Street NAKOMIS ROAD
Building Permit Number Cross Reference:
Issue Date: 11/28/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
"I FFo1.K�'
o '
JUDITH T. TERRY :,, L ; Town Hall, 53095 Main Road
TOWN CLERK : o T P.O. Box 1179
w $ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS -v/� ," Fax (516) 765-1823
MARRIAGE OFFICER ' '' .aO l1� Telephone (516) 765 1801
RECORDS MANAGEMENT OFFICER __Wli
I ,/
FREEDOM OF INFORMATION OFFICER
:v „„ /�
/ 1,��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD c,
?1 l�
TO: Southold Town Building Department -4 cr ^F,.
FROM: Linda J. Cooper, Southold Town Clerk's Office ..<,.51'6 IP
DATED: November 17, 1994 C' ,'
Transmitted herewith is a copy of application No. 1292 for a Cesspool/
Septic Tank Construction Permit submitted by:
Tony Posillico for William Burkhardt .
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.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE L/
DISAPPROVE
Comments: 1ZrrJ se, p 9'S.1.-
7
/0 .!
Signatur- iiiir
Daed 9 .
,--„,OFFICE OF THE,. TOWN CLERKPFFD
;\
Town of Southold OHO COG
Judith T. Terry, Town Clerk ate: `' , . Application No.
Town Hall 53095 Main Road o ( .: ?
:�:•-�L '` Construction
P. 0. Box 1179 �,,, ' • ,y
Southold, New York 11971 � �• ' O� •
Alteration
Telephone �! 10, Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
•
Permit No.
Fee $ /(7
DATE ///7
APPLICANT NAME: /fig Gv/t.L//.-M J/7//7/A.-;?1 j- r,4,c.6( u
APPLICANT ADDRESS: _53:3a ,4yl/z / .1-1__4-11141-44c- "--
5: /a/9/ i i ,/?K //97/
SEPTIC X CESSPOOLX ( I
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/l//--Lf! Co,Vs7A)C /v/t, Dr= _ _i.v Ge E ��f#44/6
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: W/LL/nM 23 -i7it.# 4212
OWNER MAILING ADDRESS: S ,�j2 /3AX//l=am 2)4-0
__S-OUT/i6/ I /1,/7/C //7/
OWNER PROPERTY ADDRESS: t/4'23.5S ,_.<j_
c)vr/o co /-// //97/
TELEPHONE NUMBER OF CONTACT PERSON:(S/L). - / _
J'7/oG2S/LG/C'J
TAX MAP NO. : Section ,d,( Block 03 Lot 9y, / of=
CROSS STREET: //'9kQ/72/S 1�4.?4-f3
BUILDING PERMIT NUMBER CROSS REFERENCE:. y/1/0 - �y- 009/
GIJLco ���
ignature of Applicant
RECEIVED BY:
Tow Clerk's Office
DATE: /( ^ / 7 Y
Mn»"a!'. >. .,��;4 -wr -*`•.•z�s:,x,...,� .� �s..,...a• 4 '•'°fix .. �*°$D" 'ASK
:
.e iv- 9-f-ct,9i
Marr: . '
/
1
f."-------. "---"----""1"."---------"iper /4411112007-
oftwoormice.c me 1� moot - 1 sp•1ts .Q Tom! .fAO�l3f wKL
I
o �� 1 , , . crx.Mv .cavo! q� ,idifig Jr/ �,
S =cls'E 9 4 4/. / / - /1 S_• ` I / 1, +eNr.ca - .2te .f.3a src �e
CLW4-,GlvCrQV 0.1,147" L I
7b. .< <6ito%:Vc .. I
V1 ti err z; ' f/5 QEF. ivo. 0 — • a
9 I
40, -zeal- t ,' ' ps4c1,
11
:kJ 1 %I Srd�'DLrf CO JARX iGie /y�jlvii(
r. (��� b ,,ECT ,e4:0,t_- /t - 1
7a' rrzin. c =5. �C i�avr✓ O75 <'3 Pe¢+e�T o� 1
p5 t
YdE yaresc ( .�:es 4LT�.-.5.5
$ Q 'f 4 c.Newct ! +�J,r' q Mks. wJl1/,y+1 dc�K/,df.46"T
z5,
t �/ __� S�/T,ria[!J v6.,/ N-+fX //9T/
� b1. jjpp q 2 (1)/1 11
l TEi.E'7�/EM#; €' ' -765-57V
$'I,�p -0C--4-44-.
"`rte` --� 4 \ , AEiCv 14geE .+r id'
1 r2-�T /racE
ii90 - -N 5t 45'-05,-r4r //de.0•--
cl 1 4-10( 49 wtih '- ` /�
1pl f J ,l \ t N!A'lr�cx I j
tiii W A 8,4 SS 0 -STE'EE- T p
i
r
`\
--� -- — to — I .
3 ( 1
q
ill
PLEASE NO1
1L
� � II I 1 ay
1 11
It a the applicant's responsibility to •
ma ntsln • sanitary distance'
'. �'�Sir 1 � Mfgadequat ry tangs - 1
between all sister a and.sew lI y o
,..4. ttn,Hitioet � .. d I p lei y11 i ! w r=1 n
or: t ,. .. ="lw 1t, ti, ,..,:
or 1
n
k