HomeMy WebLinkAboutKrebs, Edward i
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1 Town Hall, 53095 Main Road
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VO Off. ��` P.O. Box 1179
_',Yel � ��•0°�� Southold, New York 11971
JUDITH T.TERRY ll1 FAX(516)765-1823
TOWN CLERK TELEPHONE(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. 454 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : KREBS, EDWARD P.
Address 1 : P. O. BOX 260
City St Zip CUTCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS INDICATED ON SUBMITTED COPY OF SURVEY AND AS APPROVED BY
THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ON 5/19/88.
Name Of Owner KREBS, EDWARD P.
Mailing Address 1 P. O. BOX 260
City St Zip CUTCHOGUE NY 11935
Property Address 1 1370 CASES LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 111 .00 block 11 lot 11 .000
Cross Street PECONIC BAY BLVD
Building Permit Number Cross Reference:
Issue Date: 1/11/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
• \\tf 111.1( : JAN 01 9
y
" .' Town Hall, 53095 Main Road
`c-/0,1 P.O. Box 1179
=_ ®1 ..),"0, � Southold, New York 11971
JUDITH T.TERRY
41.1,04r tf i4-11- TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office
Dated: January 10, 1989
Transmitted herewith is a copy of application No. 462 for a Cesspool/
Septic Tank Construction Permit submitted by:
Edward P. Krebs
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 DC
DISAPPROVE
Comments: d ;c �A.o� Q uc k r 1 f7
\C.
Signature
Dated
I\ ' °\i
• ' IIiI
OFFICE OF THE TOWN CLERK t\VFOi' (pi
Town of Southold
&,Y - '
Town Clerk Application No. `T
Judith T. Terry,
Town Hall, 53095 Main Road c ?,- .;_.'s 'fi"' Construction
cnr .. .
P. 0. Box 1179 t
4:11b Alteration
Southold, New York 11971
'�
Telephone 1°_1 [ NJ\ 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 , , / 0, l9 6`i
APPLICANT NAME: Ed t the ) O Ket d
APPLICANT ADDRESS: /O do)( 2 ,o - 1320 e ,fS 4TJ 414'E
Cul I( oGUe, N._Y. lf4/. 51.3-
SEPTIC
5SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
C,, � c r Q 3 S
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Eh iti- j`t e p A [` Oe ' J s (
OWNER MAILING ADDRESS: / o 6'c )c - O
C u T C t( O G v E, IVA( 1( 13s
OWNER PROPERTY ADDRESS: / 3 'Jcti CA56
Cv ? C ff o Gly c N,Y J(?-35-
TELEPHONE
3STELEPHONE NUMBER OF CONTACT PERSON: 5 ( ‘ 73Y 6 G 6
TAX MAP NO. : Section / II Block // Lot P/b C
CROSS STREET: (2---C-cr—L-(---<--
BUILDING PERMIT NUMBER CROSS REFERENCE:..
Signature of Applicant
RECEIVED BY: /C��-Q/{'�- RECEIVED
own Clerk's Office
DATE: //U
Town Clerk Southold
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_
y • SUFFOLK CO. HEALTH DEPT. APPROVAL
•
H. S. NO.
•
SEIJGLE FAMILY DWELLING ONLY
FIRES TWC YEARS FROM DATE OF APPROVAL
I STATEMENT OF INTENT
{ EL =
.THE WATER SUPPLY AND SEWAGE DISPOSAL.
Xi+ ?--"'' es SYSTEMS FOR THIS RESIDENCE WILL
_--- \ 2256 i
IQ CONFORM TO THE STANDARDS OF THE
`'`'` ,` SUFFOLK CO. DEPT. OF HEALTH SERVICES.
I
a �� IV/ (S) APPLICANT
T.; 4��`0ee.,y"�' I SUFFOLK COUNTY DEPT. OF HEALTH
�' PC7 �GQ'p`O rl SERVICES — FOR AP RO AL OF
In , j ��,��a.\y'L r Q CONSTRUCTION ONLY c/f g7/é—
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I/ 0 H. S. REF. NO.: _
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APPROVED: .j �t.�►
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:-01\ / - - SUFFOLK CO. TAX MAP DESIGNATION:
I I DIST. SECT. BLOCK PCL.
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Approved in accordance v "gs.i d•' RP"
TEST HOLE' STAMP
determination dated
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