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OFFICE OF THE TOWN CLERK ; c)1FO(A'e'
Town of Southold
Judith T. Terry, Town Clerk �� y
Town Hall, 53095 Main Road
P. O. Box 1179 : �� :. =
Southold, New York 11971 O `'O�-
Telephone 01 * g,/
(516)
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 101 Residential X
Non-Residential
Fee $ 10.00 -
Septic Cesspool x
PERMIT ISSUED TO:
NAME: Schel Building Contractors Inc.
ADDRESS: 40 West Main Street
Riverhead, New York 11901
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
Single family residence with detached garage.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Peter F. Schleipman and Patricia M. DeMuria
OWNER MAILING ADDRESS: 66 Orange Street
Brooklyn, New York 11201
OWNER PROPERTY ADDRESS: Old Cove Road
Cutchogue, New York
TAX MAP NO. : Section 111 Block 4 Lot g
CROSS STREET: Wunneweta Road
BUILDING PERMIT NUMBER CROSS REFERENCE: Unknown
Judith T. Ter
Southold Town Clerk
DATE: January 27, 1987
I' r
(TOWN SEAL)
OFFICE OF THE TOWN CLERK
Town of SoutholdC�
Judith T. Terr y, Clerk Town ClClerkApplication No. �a /
Town Hall, 53095 Main Road Construction
P. 0. Box 1179
Southold, New York 11971 Alteration
Telephone Residential v
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL.
Permit No. V/
Fee $ l/) h"
DATE
APPLICANT NAME: �cr( _ �U J�-D i�G �f7� cT t /•i!c
APPLICANT ADDRESS: yQ W537-- /' p- --
12i v L ti- -D ,y/ , //90/ _
SEPTIC CESSPOOL X
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION SinJ&-L&--
Fg-M Ly SEs�r ��c� w i 774 ---De-rAcr--c D G-Pr'212 GL
LOCATION MAP: Must be attached hereto before permit may be Issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: -17a-reg F 5cA,I tipI,4„1 ?Pm-724-6A ri. r-7-1r U 'A
OWNER MAILING ADDRESS:6/ Q6-tr '—e-ei-
3KLvnU n/. V 1/10 J_ -
OWNER PROPERTY ADDRESS: OG-D ( v5 Th
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C'vrc-11-o y , '/ K
TELEPHONE NUMBER OF CONTACT PERSON: 369-//22_
TAX MAP NO. : Section /1/ Block O'/ Lot 0
CROSS STREET: WUAJ'J Jt O -tom!_
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: C 'y.�L�� 0'
RE( �' own .1ZIerk's Office
Town Clerk Southold
I1' . J•1,
128993
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TOWN OF SOUTHOL D •i1 �;
SUFFOLK CO., N. Y
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,_,4 ' engineering p.c.
1 ---*D„."---" ....... ... h ' 60 west main street
riverhe®d, new york 11901 ii
EL'S ARE INASSUMMED DATUM w
(516) 369-1717
AREA: 29,277 SQ.FT (0.672/Acres) 5 December 4, 1986 Job N 86-1577
THIS OUTL/NE SURVEY WAS PREPARED FROM A MAP
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