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JUDITH T. TERRY � � .G ;
Town Hall, 53095 Main Road
TOWN CLERK v T %
P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ` Southold, New York 11971
MARRIAGE OFFICER ‘.%0/% $-0�''�� 3
Tel ph onFax e (5 6) 765-18016)
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 848 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : JOHN WALTERS
Address 1 : 160A OREGON ROAD
City St Zip CUTCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
ADDITION OF ANOTHER CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. EXCAVATION INSPECTION REQUIRED. CALL SOUTHOLD
TOWN BUILDING DEPARTMENT (765-1802) FOR AN APPOINTMENT.
Name Of Owner LAUB, SANDA
Mailing Address 1 545 HUMMEL AVENUE
City St Zip SOUTHOLD NY 11971
Property Address 1 545 HUMMEL AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 63.00 block 2 lot 18.000
Cross Street YOUNGS & BOISSEAU AVENUES
Building Permit Number Cross Reference:
Issue Date: 6/04/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY : Z .G 1`. Town Hall, 53095 Main Road
TOWN CLERK : p eZr P.O. Box 1179
REGISTRAR OF VITAL STATISTICS .to �` Southold, New York 11971
MARRIAGE OFFICER V , Fax (516) 765-1823
=_ �� Telephone (516) 765-1801
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I ‘ f . ° ' 4 1992 : r OFFICE OF THE TOWN CLERK
i• s 4 TOWN OF SOUTHOLD
June 4, 1992
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A875 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
John Walters for Sandra Laub
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.
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - ,x
DISAPPROVE -
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OFFICE OF THE TOWN CLERK
Town of Southold .'' G��FF ���' g ' S
Judith T. Terry, Town Clerk Qt �l/yJ► Application N
Town Hall, 53095 Main Road Z L ; Construction
P. O. Box 1179 v . 1—.41
Alteration t/
Southold, New York 11971 ;
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