HomeMy WebLinkAboutMeyer, John „ ..
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ELIZABETH A.NEVILLE I�`Z` GZ�` Town Hall, 53095 Main Road
TOWN CLERK p '� , P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �y 4 •
Southold, New York 11971
MARRIAGE OFFICER •
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RECORDS MANAGEMENT OFFICER `�y�fo N°.
O, ,•I� Fax(516) 765-6145
Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER = '� 4,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2104 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOHN & GAIL MEYER
Address 1 : PO BOX 131
City St Zip MATTITUCK NY 11952
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 #R10-99-0119
Name Of Owner MEYER, JOHN & GAIL
Mailing Address 1 PO BOX 131
City St Zip MATTITUCK NY 11952
Property Address 1 44632 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 75.00 block 6 lot 7.002
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 7/06/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE "ik; Town Hall, 53095 Main Road
TOWN CLERK o _-, P.O. Box 1179
REGISTRAR OF VITAL STATISTICS uy Southold, New York 11971
MARRIAGE OFFICER
Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER -�y %N.1 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ....."/0.1 * ��0
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 24, 1999
Transmitted herewith is a copy of application No. 2192 for a Cesspool/
Septic Tank Construction Permit submitted by:
John and Gail Meyer
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
DISAPPROVE
Comments:
ii
ature
Dated
OFFICE OF THE TOWN CLERKS``�f
TOWN OF SOUTHOLD �� �l` `OG Application No. a i9
ELIZABETH A.NEVII J F,TOWN CLERK
P.O.BOX 1179Construction
SOUTHOLD,NEW YORK 11971 Z
^' ; Alteration
Telephone %-..!000 $10.00 -Residential ✓
(516) 765-1801 _ "1 ��,'�� $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
PErrIliftsn
APPLICATION JUN 2 4 1999
for Lown Clerk SOUtb01tl
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE a l h,
APPLICANT NAME: Ikn GYML MEA/ER
APPLICANT ADDRESS: pD BUx i 3
1n 4a-T-T f tct s 2--
SEPT I C ✓ CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
I7 Y) Imo. C"StUilr,ri ,rJ
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: J061 GRIL rn�� L12,
OWNER MAILING ADDRESS: 'd }' )3 )
ma i+ lru&k 1 1q5 a
OWNER PROPERTY ADDRESS: (O3(9. YY\cw koAD
501,01401-0 Mi IR--/ )
TELEPHONE NUMBER OF CONTACTr� PERSON: 5/69 - 734 ado'
TAX MAP NO. : Section 15 Block 0( Lot � oZ
CROSS STREET: POr ZIPA`D
BUILDING PERMIT NUMBER CROSS REFERENCE:
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Signatur of Applicant
RECEIVED BY:CW&O,.----
Town Clerk's Office
DATE: � IQua
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d Alden W. Young, P.P. & L.S. (1908-1994)
s "� Howard W. Youunngg Land Surveyor
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