HomeMy WebLinkAboutMuscheid, Jeannette 0"
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ELIZABETH A. NEVILLE �,``t 0�, � Town Hall, 53095 Main Road
TOWN CLERK t o
.t • P.O. Box 1179
y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS v� 1
MARRIAGE OFFICER
. p Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER y�fo �� I Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER :.' * i•'�
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2056 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JEANNETTE MUSCHEID
Address 1 : 93 JAMES HAWKINS ROAD
City St Zip MORICHES NY 11955
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-99-0060
Name Of Owner MUSCHEID, JEANNETTE
Mailing Address 1 93 JAMES HAWKINGS ROAD
City St Zip MORICHES NY 11955
Property Address 1 WILD CHERRY LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 52.00 block 3 lot 33.000
Cross Street BAYBERRY LANE
Building Permit Number Cross Reference:
Issue Date: 4/23/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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LIZABETH A.NEVILLE i y� 0l/y Town Hall, 53095 Main Road
TOWN CLERK % = P.O.1. `� Box 1179
••• c Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER Z tfr ,,, Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER iNg
?rzrzr
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 21, 1999
Transmitted herewith is a copy of application No. 2139 for a Cesspool/
Septic Tank Construction Permit submitted by:
Jeannette Muscheid .
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.
`tea
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments: YSigna e
Dated
Y/.2 79 9
OFFICE OF THE TOWN CLERK .11
TOWN
TOWN OF SOUTHOLD ,'I -JJ �1 CQ Application No.2`-E ?
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 : 1►•.. Construction
SOUTHOLD,NEW YORK 11971 Z
1=1 ryiAlteration
crs
Telephone A •Qom/` $10.00 - Residential
(516) 765-1801 = �l 1 � ' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for L.__ -
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
APPLICANT NAME: t3,.,.1i 1C~,t„ .- = :..°C� .�,,'
APPLICANT ADDRESS: 31 J f...,4�! ' ` `, \fr.,);„ ,.. ;
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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2 C .,r b .r .(Ale_ .,:
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: ,
OWNER OF PROPERTY: ' `
OWNER MAILING ADDRESS: ci3 \ \.. a - � .4 } .., ► _�
OWNER PROPERTY ADDRESS: IA, (. 1 L #
S-19 LLT t1 0 / b, V
TELEPHONE NUMBER OF CONTACT PERSON: B -
TAX MAP NO. : Section Ea_ Block 3 Lot 3
CROSS STREET: "� , � ' ,4. i . t.„,)",t7,4‘, \-1;)
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature o Applicant
RECEIVED BY: tOr
1 Town Cler�l ,'s Office
DATE: ,74 �✓
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