HomeMy WebLinkAboutLieblein, Melania `+ op.i.���
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ELIZABETH A. NEVILLE .Z. y z Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ** '% Fax (516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER - �� 1, 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. 2021 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
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 LIEBLEIN, MELANIA
Mailing Address 1 3200 NORTH ROAD
City St Zip GREENPORT NY 11944
Property Address 1 3200 NORTH ROAD
City St Zip GREENPORT NY 11944
Tax Map No. section 35.00 block 3 lot 4.001
Cross Street
Building Permit Number Cross Reference:
Issue Date: 3/02/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE y� t N Town Hall, 53095 Main Road
TOWN CLERK t c -� P.O. Box 1179
N Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS % Fax (516) 765-1823
MARRIAGE OFFICER ‘,0
RECORDS MANAGEMENT OFFICER ` #/# ��0,�
1�, Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER el
A,4, •1.'. 1°
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: March 2, 1999
Transmitted herewith is a copy of application No. 2105 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Melanie Lieblein .
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 - v
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
Signatur
iii) i5
Date
•
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OFFICE OF THE TOWN CLERK '"' O(Ik 1
/
TOWN OF SOUTHOLD ;'4, COG Application No. °�
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 iL Construction
SOUTHOLD,NEW YORK 11971 0 .—
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Alteration
Telephone ,ette $�Q��4/ $10.00 - Residential
(516) 765-1801 = 1 41Sao $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE MdA,
APPLICANT NAME: , -
APPLICANT ADDRESS: 76.) __ 01z.
2c xz.,-a
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
//
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ,717/r/f/1/4 A /
OWNER MAILING ADDRESS: ,i9)GrO 404/11 D=e✓
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: ?6".1.���'
TAX MAP NO. : Section 3 j Block 3 Lot
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
'2 1
Signature of Applicant
INIECINNO
RECEIVED BY:
Town rJ�1r}c's fifyi��
DATE: Ilr�l tK4
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