HomeMy WebLinkAboutWiener, Ellen •
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ELIZABETH A. NEVILLE t� & 4 Town Hall, 53095 Main Road
TOWN CLERK c .r4 P.O. Box 1179
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Southold, New York 11971
REGISTRAR OF VITAL STATISTICSA! 1
MARRIAGE OFFICER
O Fax Fax (516) 765-6145
RECORDS MANAGEMENT OFFICER `Ay) �0�/'�� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER 41 'r�,•�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2175 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : SEA BREEZE CESSPOOL
Address 1 : P.O. BOX 156
City St Zip CUTCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
ADDITION OF CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner WIENER, ELLEN & KORTCHMAR, M.
Mailing Address 1 51535 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 51535 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 63.00 block 6 lot 2.000
Cross Street JOCKEY CREEK DRIVE
Building Permit Number Cross Reference:
Issue Date: 10/22/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE •�`t`O G'1%` Town Hall, 53095 Main Road
TOWN CLERK
1=,
P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v-
Southold, New York 11971
MARRIAGE OFFICER
Fax (516) 765-6145
RECORDS MANAGEMENT OFFICER `.* � ��, Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER �' Jig "ai'�l
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED : October 13, 1999
Transmitted herewith is a copy of application No. 2262 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Sea Breeze Cesspool for Ellen Wiener and Mike Kortchmor
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 - �.. '
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
Signat (� '
/0/, t/(I(
Date
OFFICE OF THE TOWN CLERK ,1'' �`fDLK�
TOWN OF SOUTHOLD ��4.11.
'�� QG : Application No.aa<o
ELIZABETH A.NEVI'I.F,TOWN CLERK
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P.O.BOX 1179 1.** _ ` Construction
SOUTHOLD,NEW YORK 11971
v . ; Alteration
Telephone y0) ir0: $10.00 - Residential
(516) 765-1801 =-01 4�of'', $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION iii
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for IOWA
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CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ DATE /0-3
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APPLICANT NAME: Z , 0 ', \. ( gli 4
APPLICANT ADDRESS: V'6 ` 1 /6----. /I'7
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SEPTIC CESSPOOL
DESC' PT ION OF PROPOS d D CONSTRUCTION OR ALTERATION ., a.
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTIaN OR ALTERATION:
OWNER OF PROPERTY: #t, C, ,4 0 A. , Ail 1! .- • ...E Aft A..
OWNER MAILING ADDRESS: 1S 3 ..
, \ 0 N , , iy q7/
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: (X. 3/‘5
TAX MAP NO. : Section CoS Block c Lot
CROSS STREET: 4.,1321(2_)d.____e_yziat ..ei--S:L
BUILDING PERMIT NUMBER CROSS REFERENCE:
. 44 ;):1
7
Signature of Applicant
RECEIVED BY:t7 P3c!PL
Town Clerk's Office
DATE: TO \ V;111
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