HomeMy WebLinkAboutReiter (5) fte .0.A1
JUDITH T. TERRY o
Town Hall, 53095 Main Road
P.O. Box 1179
TOWN CLERK
REGISTRAR OF VITAL STATISTICS .� Southold, New York 11971
T
MARRIAGE OFFICER ®�
�®% .�! Fax (516) 765-1823
Y �, Telephone (516) 765-1801
-711
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 888 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO: •
Name : KATHLEEN MILNE
Address 1 : P. O. BOX 1707
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 3/19/92.
Name Of Owner REITER, BARBARA AND OTHERS
Mailing Address 1 P. O. BOX 1707
City St Zip MATTITUCK NY 11952
Property Address 1 3875 WICKHAM AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 107.00 block 9 lot 4.000
Cross Street MARY'S AVENUE
Building Permit Number Cross Reference:
Issue Date: 7/20/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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7'4
JUDITH T. TERRY ' ,I.4 Town Hall, 53095 Main Road
TOWN CLERK ® l P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �. :v` Southold, New York 11971
MARRIAGE OFFICER k V® O � ` Fax (516) 765 1823
Telephone (516) 765 1801
-
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OFFICE OF THE TOWN CLERKr
TOWN OF SOUTHOLD /// JUL ri 15 is�g
TO: Southold Town Building Department �l
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 15, 1992
Transmitted herewith is a copy of application No. 912 _ for a Cesspool/
Septic Tank Construction Permit submitted by:
Kathleen Milne for Barbara Reiter and others
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.
ce.u/ _
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations: _
APPROVE be
DISAPPROVE
2,.
Comments: q,, ei). 14.R.cs.VA \\1243), .
P•e-> ' ‘)°\\e‘k, — I
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Signature \\
\I `a 1�
Dated 111
`a IIII
b" FFICE OF THE TOWN CLERK cw:FULI'r;'
Town of Southold ���,� N ,..%.
�� -
Judith T. Terry, Town Clerk �� ` Application No. 97-a2-
Town Hall, 53095 Main RoadX k,,•,; - Construction
P. O. Box 1179 ;
c7/1
Southold, New York 11971 �• Alteration
Telephone 101 xt �� , Residential
(516) 765-1801 "1 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER- DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION -PERMIT
SEPTIC TANK or CESSPOOL '
Permit No.
Fee '$ /O
DATE 7/T1f�
APPLICANT NAME: kq (uyl in/it e •
APPLICANT ADDRESS: f). O kV/ /707
1/'6ck , figigt-
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LCite la w,( C(7 /fie s- 6e—
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /34Xdg& /eZ,(4IPr t7 OrticeVS
OWNER MAILING ADDRESS: Ao ,
f a64'IttA /` //9/02i
OWNER PROPERTY ADDRESS: 3S75 0(eidtim. GIVGgcc.e
s i ` d" /
� (/y' l/?fes
TELEPHONE NUMBER OF CONTACT PERSON 57(P D2 $ (J
TAX MAP NO. : Section /0 7 - Block q Lot 171
CROSS STREET: ` 7')
BUILDING PERMIT NUMBER CROSS REFERENCE:_
4(77/(e (�fi�.�
Signature of Applicant
RECEIVED BY: ,
Town Clerk's .Office '
DATE: `7//..57c
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Greenport N.Y. 11944
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N.Y. Lic.# 25626
Dated: 6/20/91 •
"1 i
Elevations shown are based on National Geodetic •
Vertical Datum. ,, '' ii
W
- HEALTH "I am familiar with the standards ( 1 cc
DEPT. for approval and construction of �•/ O
STATEMENT subsurface sewage disposal systems 7
for single family residences and
will abide by the conditions set
forth therein and on the permit to
construct f::1 ;w
z
' 'SIGNED: A (Jr)
&/
BARB REITER
NOTE: -Public water main not available with-in 1.1 +
500 feet of property.
-The locations of wells and cesspools shown
hereon are from field observations and of CC ` U
,d from data obtained from others. ■ ■
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IV4�� `\\ "- OREGO
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LOCATION PLAN . .,, , •
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SINDOLS COUNTY DEPARTMENT O9 RERUN SERVICES
COR APPROVAL OF CONSTRUCTION CF
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2 I v:;gle Family Residence OffIY , 44176 'a'
y \GESS cS � rExi .74:14 M SREP.NO cit. O—C••' E ,
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\ -. �?s PAO YEARS FROM ;£ r APPROVAL "Pkof.die {3~�
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Pr•OPosED �� �` `� Checked By TS
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