HomeMy WebLinkAboutLauer, Charles •
OFFICE OF THE TOWN CLERK c3 ULA,
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of Southold Q,c51
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Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 1197171
Telephone 1l * ��
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 32 Residential xx
Non-Residential
Fee $ 10.00
Septic Cesspool Xx
PERMIT ISSUED TO:
NAME: Charles L. Lauer
ADDRESS: Box 2883, Friends Road
Setauket, New York 11733
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Residential Dwelling
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Charles L. Lauer
OWNER MAILING ADDRESS: Box 2883, Friends Road
Setauket, New York 11733
OWNER PROPERTY ADDRESS: 895 Greenfield Lane
Southold, New York 11971
• TAX MAP NO. : Section 63 Block 1 Lot 31
CROSS STREET: Barley Lane
BUILDING PERMIT NUMBER CROSS REFERENCE: Pending
Judith r `Terry
Southold Town Clerk
DATE : September 9, 1986
(TOWN SEAL)
OFFICE OF THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk Application No.�
Town Hall, 53095 Main Road Construction L
P. 0. Box 1179
Southold, New York 11971 Alteration
Telephone 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.'303
Fee $ //)
DATE OAt
APPLICANT NAME: r C,�Wei' L , L C,tu_&v-
APPLICANT ADDRESS: aC �F3 /�'te.vrc Kms..
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SEPTIC V CESSPOOL
DESCRIPTION pF PROP SED 5ONSTRUCTION R ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CON TRR�UCTION OR ALTERATION:
OWNER OF PROPERTY: -&
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OWNER MAILING ADDRESS: .)'Pa', - -e-/e-i-c {
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OWNER PROPERTY ADDRESS: 91"" &f--ek,47� Lane
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TELEPHONE NUMBER OF CONTACT PERSON: 7,17- a f
TAX MAP NO. : Section (.p, Block 0647f Lot JiCROSS STREET: +Ayr f " �t p` Lai? e
BUILDING PERMIT NUMBER CROSS REFERENCE:
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Signature of Applicant
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RECEIVED BY: lir '
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SUFFOLK CO. HEALTH DEPT. APPROVAL
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