HomeMy WebLinkAboutDuerwald, Andrew (2) ' „,,,,/,ii i
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Town Hall, 53095 Main Road
%0 ��� P.O. Box 1179
' lol 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
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 342 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : JOHN BERTANI BUILDER INC.
Address 1: 1380 OAKWOOD DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM
APPROVED AS SUBMITTED AND AS PER SUFFOLK COUNTY HEALTH DEPARTMENT
APPROVAL.
Name Of Owner DUERWALD, ANDREW & MARGARET
Mailing Address 1 27 CONNELLY ROAD
City St Zip HUNTINGTON NY 11743
Property Address 1 KIMBERLY LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 13 lot 20. 006
Cross Street PINE NECK ROAD
Building Permit Number Cross Reference:
Issue Date: 5/23/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
1 :tr 11 II
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I I MP 2 3.4
•
- ? t• Town Hall, 53095 Main Road
. .... It '`'�0- P.O. Box 728
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Southold, New York 11971
JUDITI1 T.TERRY TELEPHONE
TOWN CLER1:
(516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE QF THE TOWN CLERK
TOWN OF SOUTHOLD
•
May 23, 1988
To: Victor 'Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 347 for a -
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by John Bertani for Margaret and Andrew Duerwald •
Please review the application and locatipn 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.
er •
de4044
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 - x'
DISAPPROVE -
A.
COMMENTS: Q..o 4 A... daiMCPWAL
: )*ate, a,�
Signature
d.1.219
Date
r 1
,g ii_i�
OFFICE OF THE TOWN CLERK c0FOUr
Town of Southold 0< 4 Cal/
. „L Application No. L39 7
Judith T. Terry, Town Clerk -
Town Hall, 53095 Main Road j'C Construction
P. 0. Box 1179
Southold, New York 11971 0,y�. O�.`J Alteration
Telephone _OI ��; �� 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 $ / p , 1")
DATE inQ,,L/ / I lP °
APPLICANT NAME: JOhn I r ni to 1cLer' v
APPLICANT ADDRESS: 13J-O OCOC-“AIU,4_,, /Or
Sscr f-010 / i Ai I(9--i
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION Nari-f(,t, r '
cri- o— OTh - rfrA..rn , l e/use,/I it `
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: �r cu-c_+- �c �
c rct,j19( r")aI d
OWNER MAILING ADDRESS: a Ccn1_//L,/ 1�
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OWNER PROPERTY ADDRESS: �j berlli 11J
SO uifi,o lv f //9-)i
TELEPHONE NUMBER OF CONTACT PERSON: 76,s-- icq51
TAX MAP NO. : Section 70 Block /3 Lot 02 0. 6
CROSS STREET: x..41.4 .i: --
BUILDING PERMIT NUMBER CROSS REFERENCE: r
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Ak a., . 14„,' I k, 7 .# .
Signature of Applican
.�r
RECEIVED BY: ` ` c ,
own Jerk' Office
DATE: L /
A
E EavE
' PINE NECK ROAD
MAY 2 01988
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