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HomeMy WebLinkAboutDank, Leonard II to. JUDITH T. TERRY Town Hall, 53095 Main Road TOWN CLERK T P.O. Box 1 179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER Q Fax (516) 765-1823 •rAin Nro'rr�� Telephone (516) 765-1801 lit I% �..�/i///rr r OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1011 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 INSTALLATION OF SEPTIC TANK AND LEACHING POOL. APPROVED AS SUBMITTED. EXCAVATION INSPECTION REQUIRED. Name Of Owner DANK, LEONARD Mailing Address 1 P. O. BOX 194 800 COX LANE City St Zip CUTCHOGUE NY 11935 Property Address 1 SMITH DRIVE NORTH City St Zip SOUTHOLD NY 11971 Tax Map No. section 76.00 block 2 lot 1 .000 Cross Street MAIN BAYV I EW ROAD Building Permit Number Cross Reference: Issue Date: 6/08/93o Judith T. Ter Southold Town Clerk (TOWN SEAL) (( lEuN - 71993 Gy JUDITH T. TERR F [ C. ` : Town Hall, 53095 Main Road TOWN CLERK T01h`T T P.O. Box 1179 REGISTRAR OF VITAL STATISTICS � Southold, New York 11971 MARRIAGE OFFICER 0Q , Fax (516) 765-1823 = /I,1 �1Drr rr� Telephone (516) 765-1801 a OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda Cooper, Southold Town Clerk's Office DATED: June 7, 1993 Transmitted herewith is a copy of application No. A1040 for an ALTERATION PERMIT for a cesspool or septic system submitted by Gary Tabor for Leonard Dank . 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. ii Linda J. Cooper * * * * * * * * * * * * * I have reviewed the application and location map of the project listed above and make the following recommendation: APPROVE - DISAPPROVE - COMMENTS: EXCAVATION 2 REQUI ` ;1 L/ i Signature Da % 'OFFICE OF THE TOWN CLERK S�FFOLA' Town of Southold ��� COQ; Application No. /DO Judith T. Terry, Town Clerk -4. ; Town Hall, 53095 Main Road . a j�C Construction P. O. Box 1179 Alteration �� Southold, New York 11971 ��-.'' Telephone �l �t �� � Residential ✓ (516) 765-1801 Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICAT ION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ n DATE / 7tJ APPLICANT NAME: l J`/52t" / 7--1 O 0 /- APPLICANT APPLICANT ADDRESS: > Fr ii/;9 1/.y S 7 ( ki ' civ / SEPTIC VCESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION "7/5 `-rte/ • © C) • - d - , ' _ - b X r A t7,9G!�. l j /70 Cd LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: A C 0 11/4711 CZ D.9 hl/T /046 C ?I 7pa Coy,L0. OWNER MAILING ADDRESS: p Gw OWNER PROPERTY ADDRESS: Ste, '% ' WO . So j --71/-e S 77 C i -e- t_ I>_ TELEPHONE NUMBER OF CONTACT PERSON: 3 - 3 _ 2 l o 7 TAX MAP NO. : Section 7 6 Block Lot CROSS STREET: /0-7,4P, 'i✓ ,/ 2-', /r 4, BUILDING PERMIT NUMBER CROSS REFERENCE: ______A Sig ure of Applicant RECEIVED BY: UMJACIA.---4 /_ own Clerk's Office DATE: (y /3 e_s4 A 1-17 pc) / 0 0 frt-^- 17/-c, / '7,' a r,s -e-// S © idfc ,? VI° ► --toe.// Fp.,/e®- .a C t •��mit 'ye .,_7 'C- 9OO 7/ G a,. .1 11,