HomeMy WebLinkAboutKraemer, Stuart ��,��o��FFO�KCD�i
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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK : p rZ P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER ‘%V.4.4, ��' Fax (516) 765-1823
� Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 839 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : STUART KRAEMER
Address 1 : 406 SOUTH 8TH STREET
City St Zip LINDENHURST NY 11757
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 4/30/92.
Name Of Owner KRAEMER, STUART
Mailing Address 1 406 SOUTH 8TH STREET'
City St Zip LINDENHURST NY 11757
Property Address 1 KENNYS ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 59.00 block 7 lot 31 .001
Cross Street MIDDLE ROAD
Building Permit Number Cross Reference:
Issue Date: 5/11/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
r
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$to
$4 °yam:
JUDITH T. TERRY : Z .4. t Town Hall, 53095 Main Road
TOWN CLERK : p rr i P.O. Box 1179
REGISTRAR OF VITAL STATISTICS .un w ` Southold, New York 11971
MARRIAGE OFFICER �4, Fax (516) 765-1823
‘-?...74:416•1 $`6 it s01
� Fax
(516) 765 1801
OFFICE OF THE TOWN CLERK Dg IN 0\n--,q,
TOWN OF SOUTHOLD MAY 5 992
To: Southold Town Code Enforcement Officer el t Y , " t
From: Linda Cooper, Southold Town Clerk's Office
Dated: May 5, 1992
Transmitted herewith is a copy of application No. 863 for a Cesspool/
Septic Tank Construction Permit submitted by:
STUART KRAEMER .
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE ''J<
DISAPPROVE
Comments: 1 a
A� of 4
)) eo. Lcat \-- 9
Cc..95-CiA. ctt..g2—
Signature
Dated
OFFICE OF THE TOWN CLERK c\c:\Vf ,�,;•
Town of Southold �, �{ �0 Q
Judith T. Terry, Town Clerk ��r,'. K: Application No. U
Town Hall, 53095 Main Road li, ,,.y , Construction I
P. O. Box 1179
Southold, New York 11971 Alteration
ri
Telephone X01 x [ *6, Residential ✓
(516) 765-1801 "� Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$/D
DATE :..1579-2—
APPLICANT NAME: Sj i/A,j / fly yy2FR.
APPLICANT ADDRESS: YO ' 5QUr� C5277-/77-/ •
�S;•
L/AIP6/1/M,/R5 7 /t/ X. // 757
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/V E S;D A177/9L &i F 17 x HovS&
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION :
OWNER OF PROPERTY: ,J'OMj-7 /rk _ Y1�-�
OWNER MAILING ADDRESS: `/e‘ :5 (L)77 (54-7
S TH 5-�-•
L>V PEN/t'12R 575 /1/. y. /1 75 7
OWNER PROPERTY ADDRESS: �EA/NEy,S Ro;9/
5007-/-10L2) r 2\/,Y-
TELEPHONE NUMBER OF CONTACT PERSON: Hoy-1E
7� - .3— 5 - 6J
/(or�� - zS-o�X3
TAX MAP NO. : Section 05-9 Block 7 Lot 3 /. /
CROSS STREET: /L)/LL ROM)
BUILDING PERMIT NUMBER CROSS REFERENCE:_.
Signature of Applicant
RECEIVED BY :o ,c-<-_ C �v
Town clerk's Office
DATE: in S 11I .L-J
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SUFFOLK CO.HEALTH DEPT.APPROVAL
S. NO. r
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STATEMENT OF INTENT
GRATTAN I 1
(VACAt-11") I• THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
506:a9
' CONFORM TO THE STANDARDS OF THE
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to SUFFOLK CO. DEPT. OF HEALTH SERVICES. i
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1 SERVICES - FOR APPROVAL FOR
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a 'i _ 3Al2 ' __L CONSTRUCTION ONLY
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, PROP 0G-IVe
DATE: APR 30 top
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