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HomeMy WebLinkAboutHenn (2) 41, twogi, q11maw ; Town Hall, 53095 Main Road � T� �o" P.O. Box 1179 -� � � ' Southold, New York 11971 JUDITH T.TERRY ?.. ,zi /11 FAX(516)765-1823 TOWN CLERK TELEPHONE(516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 612 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : ROBERT HENN Address 1 : 1050 SMITH ROAD City St Zip PECONIC NY 11958 Descripton of Proposed Construction or Alteration REPLACEMENT OF EXISTING SYSTEM WHICH WAS DESTROYED BY MACHINERY. APPROVED AS SUBMITTED. NEW TO BE PLACED EXACTLY WHERE EXISTING WAS LOCATED. EXCAVATION INSPECTION REQUIRED. CALL SOUTHOLD TOWN BUILDING DEPARTMENT (765-1802) FOR AN APPOINTMENT. Name Of Owner HENN, ROBERT Mailing Address 1 1050 SMITH ROAD City St Zip PECONIC NY 11958 Property Address 1 1050 SMITH ROAD City St Zip PECONIC NY 11958 Tax Map No. section 98.00 block 3 lot 28.000 Cross Street INDIAN NECK LANE Building Permit Number Cross Reference: Issue Date: 5/14/90 Judith T. Terry Southold Town Clerk (TOWN SEAL) i' �f CSPULk- Z %. ,.._. 4 ,ii*.'., % �q \ ® r5 r ,, ,T..4. ith �, ,� Town Hall, 53095 Main Road _d,® ` 1 _®�',.. P.O. Box 1179 1 * 'i .o 9 Southold, New York 11971 JUDITH T. TERRY "'�.irom��"IPt TELEPHONE TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK r;,, ,- ,:, --,,,: _-. .1 TOWN OF SOUTHOLD ` I. `<ff May 8, 1990 ;' MAY o 8 10 PAL..,,. To: Southold Town Code Enforcement 'Officer r !n�gLDG. DEPT �L w `d OV i 4.neC a31h°)M.s k h-oOLD From: Linda J. Cooper, Southold Town Clerk's Office Transmitted herewith is a copy of application No. A 626 for an ALTERATION PERMIT for a cesspool or septic system submitted by Robert Henn . 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 - x DISAPPROVE - COMMENTS: Q„ 19.4,' � a-1 efk, . . 10 ;14-0 `"r 0 Ls, e..._.c...,.. ,,,,......„ „..,,.....,.... ..‘„,,,,,„ 1..,4.9•wo ®I .....,..,...Q. -,. ���ko�( �� SignatureN(ia,.... WAY 11 199U c,is0 c0... sl /eil qv Date *Mt Mutt,$ so �l`� e „ , OFFICE OF THE TOWN CLERK ' ' 4COrO ''/ OS �eD Town of Southold '\ Application No. 6 ,2-4,Judith T. Terry, Town Cler `” Town Hall, 53095 Main Road �� Construction P. O. Box 1179 Southold, New York 11971 Alteration Telephone �l [ Ng .9/ Residential (516) 765-1801 Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT • SEPTIC TANK or CESSPOOL Permit No. Fee $ /0 — DATE M A t' i 9 0 rr J APPLICANT NAME: Q_e:s) E kr T ?(-1e v\ 1/-\ APPLICANT ADDRESS: \ 0 CO S U\A I ` IA PetR 10 P G c c-YI I C SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION x S� In Svi- Ce G P oo E re'S-► �P �c� ho c - e c _)lpc-) r LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: 4 OWNER MAILING ADDRESS: 10 S-G S M /TM (2 (I Pc_c_cf9-Y1`1 G - OWNER PROPERTY ADDRESS: SoJyy'l-Q • TELEPHONE NUMBER OF CONTACT PERSON: 7 3 TAX MAP NO. : Section 09 S) ;©o Block° 3 , ® o Lot © 2 E , ®d 0 CROSS STREET: t CZ'.v1 e--1C- BUILDING PERMIT NUMBER CROSS REFERENCE: a-QA4...47) Signature of Applicant C36C QVg® RECEIVED BY: QM pawn Clerk's Office DATE: votmaaeL . ,„ 5m, ( TA 60,(0 5A g As ciq ) r 10 itai3 erma bilsOtioa