HomeMy WebLinkAboutDubner, Steven y
� y —`22 N Town Hall, 53095 Main Road
C"<" P.O. Box 1179
`t& . � .,� Southold, New York 11971
JUDITH T.TERRY i TELEPHONE
TOWN CLI RK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
January 27, 1987
Steven Dubner
690 Deer Park Avenue
Dix Hill, New York 11746
Re: Cox Lane
Cutchogue, New York
Enclosed herewith is the Construction, Alteration or Modification
Permit for a Septic Tank or Cesspool System for which you applied.
Please be advised that each owner of real property operating an
on-site sewage disposal system, such as a septic tank or cesspool must,
prior to such operation, possess in the name of the owner an Operation
Permit for the system. The Operation Permit is issued by the Town
Clerk's Office.
The fee for an Operation Permit is ten dollars ($10.00) for
residential use and twenty-five dollars ($25. 00) for non-residential.
Please have the owner complete the enclosed Application for an Operation
Permit and return it to this office along with the proper fee.
For your general information I have enclosed an Informational
Bulletin regarding the Scavenger Waste Laws adopted by the Southold
Town Board. Should you have any questions pertaining to either permits
or the Scavenger Waste Laws, please do not hesitate to contact this
office. We will be glad to assist you in any way possible.
Very truly Yours,
Orldesedia404
Judith T. Terry
Southold Town Clerk
Enclosures (3)
JTT/Ijc
OFFICE OF THE TOWN CLERK c31Feut-4,
Town of Southold DO OG
Judith T. Terry, Town Clerk 1"
Town Hall, 53095 Main Road
P. O. Box 1179 �,:
Southold, New York 11971 Off �- ��
Telephone :VI * ro
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 100 ResidentialX
Non-Residential
Fee $ 10.00
Septic Cesspool x
PERMIT ISSUED TO:
NAME: Steven Dubner
ADDRESS: 690 Deer Park Avenue
Dix Hill, New Yb:rk 11746
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
One story, single family dwelling
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Steven Dubner
OWNER MAILING ADDRESS: 690 Deer Park Avenue
Dix Hills, New York 11746
OWNER PROPERTY ADDRESS : Cox Lane
Cutchogue, New York
TAX MAP NO. : Section 84 Block 4 Lot 6,1
CROSS STREET: Middle Road
BUILDING PERMIT NUMBER CROSS REFERENCE: Unavai a. e
Judith T. Terry al
Southold Town Clerk
DATE: January 27, 1987
(TOWN SEAL)
,� 1
ICJ \FOU^^I‘'
t AV
• �' �tob `� `� Town Hall 53095 Main Road
ft•' P.O. Box 728
,�, • ' Southold, New York 11971
�.,..
JUDITH T.TERRY TELEPHONE
TowN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
January 6, 1987
To: Victor Lessard, Southold Town Building Department -
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 98 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Steven Dubner
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
•Judith T. Terry
Southold Town Clerk
* * * * * * * ' *
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE -
' DISAPPROVE -
COMMENTS:
4
Signature
Date
OFFICE 3F THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk Application No. 7‘r
Town Hall, 53095 Main Road Construction
P. O. Box 1179 -
Southold, New York 11 971 Alteration_
Telephone 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 $
DATE /— `P 7
APPLICANT NAME: J ) �uB►)Q
APPLICANT ADDRESS: PC% 'OsE2 A2� Au-El
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
\ "FA nit �� �r✓Ga 1 ��J - , <�-p2 4✓
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY : T Vim"'
OWNER MAILING ADDRESS: Sm—
OWNER PROPERTY ADDRESS: C=C)( LA►.) C� � c t-d�C C /N '
TELEPHONE NUMBER OF CONTACT PERSON: c: 12-(2). - (2)cb
TAX MAP NO. : Section 4- Block 4 Lot 6, I ��
CROSS STREET: "-t r)nL �D
BUILDING PERMIT NUMBER CROSS REFERENCE:
--Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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