HomeMy WebLinkAboutLademann, Michael OFFICE OF THE TOWN CLERK cOFOUrt,OG
Town of Southold
Judith T. Terry, Town Clerk
Tow i Hall, 53095 Main Road
P. O. Box 1179 %
Southold, New York 11971 O ff- `
Telephone -cgO! * $,V„ ../
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD D WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.236 Residential • X
Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Michael and Elizabeth Lademann
ADDRESS: 645 Pine Neck Road
Southold, New York 11971
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Cesspool System
APPROVED as per Suffolk County Health Department approval.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Michael and Elizabeth Lademann
OWNER MAILING ADDRESS: 645 Pine Neck Road
Southold, New York 11971
OWNER PROPERTY ADDRESS: Stillwater Avenue
Cutchoque, New York
TAX MAP NO. : Section 103 Block 1 Lot 19.6
CROSS STREET: Main Road
BUILDING PERMIT NUMBER CROSS REFERENCE:
s
7/57,0
Judith7T-i-gOry
Southold Town Clerk
DATE : October 20, 1987
(TOWN SEAL)
7.213Eurin
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' t} ; BLDG. DEPT.
; � 't �,� TOWN OF SOUTHOLD
•_`.0' t •• 4"••••••"----n own 1-�ali, you i Main Road
-_ljll a' .7\b ,•• P.O. Box 728
,pSouthold, New York 11971
JUDITH T.TERRY TELEPHONE
TOWN Cu-:RI:
(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
October 14, 1987
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 241 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Michael and Elizabeth Lactemann
Please review the application and location 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.
•
ordeir4i
iomareassomme
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 - �(
DISAPPROVE -
COMMENTS: Q,o J.t.JA:c.w . �l%I• i.l91 .eco• 14..14k0iLI e
•
•
Signature
of- 7
Date
OFFICE OF THE TOWN CLERK OcOret/�'
Judith T. n off SouTown Clerk � °C� Application No. j //
Terry, � .
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 O !, Alteration
! t � � Residential ✓
Telephone
(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 O C.- -e-(,'j �`� �tt. NCI
APPLICANT NAME:--tiff C
APPLICANT ADDRESS: (01-4S— � � ��, 1 J
£o(A)-,, c
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
CO x ta-6
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:"'111 -?
OWNER MAILING ADDRESS: (,4%- -�p"�/�,��Q� (2_ �
OWNER PROPERTY ADDRESS: S-Uj ujec ts._ A j
Af. o %L.-9 , L-11c,,S
TELEPHONE NUMBER OF CONTACT PERSON:1 7&% - &40(p q W 1 (o S - 1 I lo
TAX MAP NO. : Section /0 3 Block I Lot j q . (p
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of . pplicant
RECEIVED BY :
Town,Clerk's fice
DATE:
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