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JUDITH T. TERRY �,, Town Hall, 53095 Main Road
TOWN CLERK O T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS $oUthOld, New York 11971
MARRIAGE OFFICER yQ 0� � Fax (516) 765-1823
'j/„1 Ase, Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1103 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MOHRING ENTERPRISES
Address 1 : 323 GLEN COVE AVENUE
City St Zip SEA CLIFF NY 11579
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. #R-10-94-0002
Name Of Owner DUNCAN, THOMAS
Mailing Address 1 MOHRING, RICHARD
323 GLEN COVE AVENUE
City St Zip SEA CLIFF NY 11579
Property Address 1 PARK AVENUE (LOT 18)
City St Zip SOUTHOLD NY 11971
Tax Map No. section 56.00 block 1 lot 2.013
Cross Street POND AVENUE
Building Permit Number Cross Reference:
Issue Date: 4/04/94 Judith T. Terry
Southold Town Clerk
(TOWN SFA1 1
/63
JUDITH T. TERRY - Town Hall, 53095 Main Road
TOWN CLERK : o nZ+ P.O. Box 1179
cl'� �. � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ‘VA,
y
. 0 �. ��� Fax (516) 765-1823
MARRIAGE OFFICER =_.,Lj,� _`�0 �$ Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER ,� j T .9
FREEDOM OF INFORMATION OFFICER o'�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office t�
DATED: March 14, 1994
Transmitted herewith is a copy of application No. 1139 for a Cesspool/
Septic Tank Construction Permit submitted by:
Mohring Enterprises for Thomas Duncan/Richard Mohrinq .
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 G/
DISAPPROVE
Comments: 5c/, 4 ,e/0 4 V ad, D 2-
RECEIVED
MAR 3 1 1994
Signature /
TQMl11 aid( 60ldholQ 4a/3/
Date
OFFICE OF THE TOWN CLERK c0FOCK
Town of Southold
Judith T. Terry, Town Clerk 4,% %
Judith
Application No./ /37
Town Hall, 53095 Main Road ` 9 Construction L
P. O. Box 1179 cry
Southold, New York 11971 0�i `, Alteration
Telephone _alt 0-a° 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 $ /0
DATE 3 I I j
APPLICANT NAME: V 1C-/ 10. /skid 1/0,,cv2._ Icy p s
APPLICANT `^V�
T ADDRESS: Z� ��-��,� �.�v� UP
SEPTIC / CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
I
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: IVC VV1u S t�1vLYiFy\ / 11)1cl/1.CA‘.e-A. 04c4e,'�
OWNER MAILING ADDRESS: -62_3 . W C c,ue Lee -Ci+:
1167C1
OWNER PROPERTY ADDRESS: /a- \c; j(:iy \4 '
SC,c--).\\nc-'1
TELEPHONE NUMBER OF CONTACT PERSON: 6 7• /`— 0 7e/
TAX MAP NO. : Section 34(e Block / Lot c,.? /_)
CROSS STREET: 13 2, 5.-7+ G � �
BUILDING PERMIT NUMBER CROSS REFERENCE: vt�i �(
/1"if
Signature of Appli .
RECEIVED BY: COL_t,„� o�
Town Cl k's Office
DATE:
•
Young & Young, Land Surveyors 0
Lb-,
400 Ostrander Avenue, Riverhead, New York 11901
\ .
516-727-2303
\9 ; llt
\-QpCNNZ1 265'\ EL,\! ;•1
N o o Aiden W. Y Rg11ia Engineer k Land Surveyor I<�!
'0 D Q f Thomas C. lloipert� &windier 0
N j Abrams,.Kenneth F. Abr . Land Surveyor
.\.S. \ .Ip°385• 0 E m r11 1
N• o
40 •••4'o
SUFFOLK COUNTY DEPARTMENT OF
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ill
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DATE 1.16 REF. !'10
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APPROVED Pt
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1 \- 422
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L ,_�. � £�� SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES CERTIFICATION �_'
Ems{ .� 1 AM FAWUAR YAW THE STANDARDS FOR APPROVAL AND CON
pR�SgiC. ` 45 ,\� SEWAGE DISPOSAL SY51FlAs FOR CONSTRUCTION OF SUBSURFACE
.
5 SINGLE FAMILY +
pK6 R�vRUCt' AND Wtl ABDE BY THE
) 2 SET FORTH THEREIN AND ON THE PERMIT TO CONSTRUCT.' CONDITIONS
2 p'o ,cE
C r P Ea \\ %t APPUCANrs SIGNATtNtE --�- e
O ` '`, APPLICANT: /' Ome,/VC' �^LITE eP,e/.S�£S �,/re o
0 0 W, ���\V\ STREET ADDRESS 3 (.L auE l itie,u0E
o"5 `J 111
V- s:T0 ���� aTr.ps1.� 3-1 GF STATE/U£4l e A! �CaoE //S?5
�1 TELEPHONE NUMBER / ` / ,,/ set
EL 2G v_ot wt `o* `� ( S/laJ 7/-0�Jb'� �
SURVEY FOR: ie
MOHRING ENTERPRISES, INC. lip
o N\.. ,
LOT NO. 18, "LONG POND ESTATES, SECTION ONE"
\ti
N i5. ^' 111
At: SOUTHOLD Town of: SOUTHOLD °
Suffolk County, New York Isj1
9 e. Suff. Co. Tax Map: , 1000 , se , I , z I3 ''i1
rt •'il5' Pv CNv District Section Bled, Lau
00.
V3140CERTIFIED TO' ,!
OF NEhe
,Qt- 00_W Y
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lig
LED IN THE OFFICE NOTE !'
FFOL�C COUNTY ON ELEVATIONS SHOWN HEREON WERE k y
E NO. 8037. • APPROXIMATED FROM TOPOGRAPHICAL `'�i .L . n r ;� DATE :DEC.9, 1993
MAPS PREPARED BY OTHERS AND �� •l�.. �. ,
REF , t . . .
ERENCEO TO MEAN SEA LEVEL DATUM. }1 � =1 *�00
• JOB N0. i 1191
1111111 ..1 . _ SHEET NO._-:11! !FBF I' �',