HomeMy WebLinkAboutDors, Richard ',,0,
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JUDITH T.TERRY ,� :4 ‘‘ Town Hall, 53095 Main Road
TOWN CLERK t y = t P.O.Box 1179
,tt Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER yP 1 tl Fax(516)765-1823
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RECORDS MANAGEMENT OFFICER .� `�►a��,• Telephone(516)765-1800
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. 1378 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ARTCO DRAINAGE CORP.
Address 1 : 7470 ROUTE 48
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF A CEESPOOL 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 DORS, RICHARD
Mailing Address 1 32 BRONSON LANE
City St Zip PALM COAST FL 32137
Property Address 1 SOUND AVENUE
City St Zip GREENPORT NY 11944
Tax Map No. section 33.00 block 4 lot 74.000
Cross Street ROUTE 48
Building Permit Number Cross Reference:
Issue Date: 9/06/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY ;o - Town Hall, 53095 Main Road
TOWN CLERK cia Z 4 P.O.Box 1179
0 ',1 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER L, 1 Fax(516)765-1823
y� 1/
RECORDS MANAGEMENT OFFICER of , *s, Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER '��� ,•••-
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department '7 3
1.9,95
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: August 23, 1995
Transmitted herewith is a copy of application No. A1430 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
ARTCO for Richard Dors
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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OFFICE' OF THE TOWN CLERK
Town of Southold tFOtk
Judith T. Terry, Town Clerk ��' �c Application No.
.�.
Town Hall, 53095 Main Road z Construction
P. O. Box. 1179 , = M ; Alteration
Southold, New York 11971 ;tts W;
Telephone ,"O,y�o ��0. $10.00 - Residential
(516) 765-1801 = 1 4 ,, '' $25.00 - Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE - z3 ~5Si
APPLICANT NAME:_ t-t-e -I-ep Df' =t Iv Ai e Co c')9
APPLICANT ADDRESS: 7'f 70 ,,. D, 1-ce
vv)-a_1-1-•-1 1-vt_c 1t-- VU
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SEPTIC CESSPOOL x
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION /FDD ilMITIOMA L
C e cc,P 50 L is-roi. C`i si-:e w►
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: rPu d?
OWNER MAILING ADDRESS: 32. 6POI' O i 61--e_.
,p 0.12ivvy b o-0+ -C '-- 37_1 31
OWNER PROPERTY ADDRESS: O(,(11.) 1) q,Ue.
GE-iv ireOrT TV L
TELEPHONE NUMBER OF CONTACT PERSON:,�
TAX MAP NO. : Section 33 Block 4 Lot -7�
CROSS STREET: 29
BUILDING PERMIT NUMBER CROSS REFERENCE:
2 ,.___
" Signature of Applicant
RECEIVED BY: LA),(14______--
T wn Clerk's Office
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DATE: 3 /9S
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