HomeMy WebLinkAboutKrebs, Edward (2) ,1�' oc��FFOLKc.PGfr y=
JUDITH T. TERRY Z . Town Hall, 53095 Main Road
TOWN CLERK : vr=r+ : P.O. Box 1179
if' $ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = VO 0�. � Fax (516) 765-1823
MARRIAGE OFFICER '' � •" Fax
(516) 765-1801
RECORDS MANAGEMENT OFFICER = .'
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1149 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECON I C CESSPOOL SERVICE
Address 1 : P. O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
REPLACE OLD CESSPOOL WITH NEW TYPE. EXCAVATION INSPECTION REQUIRED.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS & PROPERTY LINES. NOTE: DO NOT GET CLOSER TO EXISTING WELL
ON PROPERTY NOR ANY WELL IF THEY DON'T MEET REQUIRED SETBACKS.
Name Of Owner KREBS, EDWARD
Mailing Address 1 3340 HAYWATERS ROAD
City St Zip CUTCHOGUE NY 11935
Property Address 1 275 HAMILTON AVENUE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 137.00 block 5 lot 18.000
Cross Street FLEETWOOD ROAD
Building Permit Number Cross Reference:
Issue Date: 6/09/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
of
JUDITH T. TERRY : ` ; Town Hall, 53095 Main Road
TOWN CLERK : c T : P.O. Box 1179
N � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 10 �� Fax (516) 765-1823
MARRIAGE OFFICER //���� 0O �� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER � •i�
FREEDOM OF INFORMATION OFFICER ,,,,,,��
11 U
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD , 1;lr„ 6 sal
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: June 3, 1994
Transmitted herewith is a copy of application No. A1189 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Robert Olmsted
Please review the application and location map and advise if this office may
issue the permit.
Please complete the form below and return it to this office.
Thank you.
-1c.c€ct
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE -
DISAPPROVE - EXCAVATION INSPECTION
)REQUIRED_
COMMENTS: G1.4; t.ee � � j
fi,e,777 ai4,0444,44/
Signature
Date
c
OFFICE OF THE TOWN CLERK ,,''",,,""
Town of Southold .'' ,c1 001./(`'"
Judith T. Terry, Town Clerk � � _ Application No./l e(
Town Hall, 53095 cf./v&--s
Main Road $ Construction
P. O. Box 1179 ; c m ; Alteration
Southold, New York 11971 �� r; L�
Tele hone � 0,y Q�i� $10.00 - Residential
p
(516) 765-1801 = l I."� �� $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE VVI5‘
APPLICANT NAME:
APPLICANT ADDRESS: i - L—
� �, � �- y //0"2,_
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
2 -e 12 -1
(.''L -Ll _en.,zr-
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTE
/RATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: /2-2—Z, / /' ,A1
e, • //9f'
OWNER PROPERTY ADDRESS: '--
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section / / Block 7 Lot / 'f, ' 2_
CROSS STREET: (7t2:-
BUILDING PERMIT NUMBER CROSS REFERENCE:
//4 ,(Zr
RECEIVED Signa re of Applicant
RECEIVED BY: JUN 3 1994
Town Clerk's Office
Town Clerk Southold
DATE:
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