HomeMy WebLinkAboutSchrader, Dennis 01" N -
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Off' G Town Hall, 53095 Main Road
• ELIZABETH A.NEVILLE may. Town
TOWN CLERK ,� c -� r P.O. Box 1179
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ti 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �� Fax (516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER \"4, �0. Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER - 01 4,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 86 N Residential Non-Residential X
Fee $ 25.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : DENNIS SCHRADER
Address 1 : 1160 EAST MILL ROAD
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR GREENHOUSE AND BUILDING WITH BATHROOM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #C10-97-13
Name Of Owner SCHRADER, DENNIS
Mailing Address 1 1160 EAST MILL ROAD
City St Zip MATTITUCK NY 11952
Property Address 1 1160 EAST MILL ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 107.00 block 1 lot 2.002
Cross Street GRAND AVENUE
Building Permit Number Cross Reference:
Issue Date: 12/15/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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"� �azr� ASSINIMs.
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'ELIZABETH A.NEVILLE • y0 ( . \ Town Hall, 53095 Main Road
TOWN CLERK •� = . r P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS ti Z Southold, New York 11971
MARRIAGE OFFICER % 0 ** • Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER ` ttot 0- 0 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER -.1 � ' ' /
I
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 14, 1998
Transmitted herewith is a copy of application No. 2062 for a Cesspool/
Septic Tank Construction Permit submitted by:
Dennis Schrader
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 k
DISAPPROVE
Comments: 2ignatu e
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Dated
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OFFICE.OF THE TOWN CLERK ,
TOWN OF SOUTHOLD
` �� �J QQ :. Application No. �Ql/
p�
Fi.T7ABETH A.NEVILLE,TOWN CLERK ' 1
I4 : Construction 1/".""P.O.BOX 1179 _
SOUTHOLD,NEW YORK 11971
Alteration
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Telephone ,� �
Jiv/ $10.00 - Residential
(516) 765-1801 -_4L ," $25.00 -Non-Residential ✓
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
REGEfVrn
CONSTRUCTION or ALTERATION PERMIT
DEC 1 4 1998
SEPTIC TANK or CESSPOOL
Town Clerk Southold
Permit No.
Fee $
DATE / c-':\ q?
APPLICANT NAME:J
APPLICANT ADDRESS: //61 EA5T- /Yl (LL NO
WATT t'[ Jt K, 0✓�/. /1`(1-,9
SEPTIC X CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 0wMS .SC hF-17 x 01-
OWNER MAILING ADDRESS: ( () U -QST !'y),'L L ?�O
t/Yv9 77-l T?2vk/ O✓y -
OWNER PROPERTY ADDRESS: Sfsof\F
TELEPHONE NUMBER OF CONTACT PERSON: 5i16 .-,?,9g - 3S"/ 0
TAX MAP NO. : Section 01 Block C l Lot ON ,
CROSS STREET: b,fl
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: .(7q1 CdkA, .._
Town Clerk's Office
DATE: 10- 11,41`t g
WELL DETALS 7TERE AlIE AIF!POTEH71A1Q�uOF
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SUBIERSBL£•*HERS ! 700 FT. OFPRp�RTY. ti ,4"-11.7-74-• tlf'�
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TOW�1N� OF/►�7 IWJTHOLD
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