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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK - v T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ` Southold, New York 11971
MARRIAGE OFFICER Q �' Fax (516) 765-1823
$1 9®01 Fax
(516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 952 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ROBERT AND JOAN LOVE
Address 1 : 42 WHITEWOOD DRIVE
City St Zip ROCKY POINT NY 11778
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 1/5/93.
Name Of Owner SCHMIDT, ROY
Mailing Address 1 P. O. BOX 841
City St Zip HILLSBOROUGH NC 27278
Property Address 1 ABORN LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 118.00 block 5 lot 5.000
Cross Street NASSAU POINT ROAD
Building Permit Number Cross Reference:
Issue Date: 1/15/93 Judith T. Terry
Southold Town Clerk
(Towns I I),I 1
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JUDITH T. TERRY y Town Hall, 53095 Main Road
TOWN CLERK i ( g4P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ( A`' Southold, New York 11971
MARRIAGE OFFICER �® .tr Fax (516) 765-1823
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'P®IPl� Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK •- - ,
TOWN OF SOUTHOLD '
TO: Southold Town Building Department 'A JAN — 5 1993 '`'
FROM: Linda Cooper, Southold Town Clerk's Office u' j,*:,Vio 't
DATED: January 5, 1993 TOWN OF SOUTHOLD )
Transmitted herewith is a copy of application No. 979 for an
MX E APFON PERMIT for a cesspool or septic system submitted by
Construction
Robert A. & Joan Love for Roy Schmidt
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 - AC
DISAPPROVE -
COMMENTS: csi0 .1, A.�c__xth eZ a+/ Cii Q l'A 4 41..,
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OFFICE OF THE TOWN CLERK
Town of Southold �Oi •
Judith T. Terry, Town Clerk rr ` Application No. ��l
Town HalI,i453095 Main Road o i.f;v "� � Construction
P. O. Box 1179 Wit. ' 11J2t.;y
Southold, New York 11971 Alteration
u fit' v
Telephone ' del r ��,{f� Residential I.—
-
Telephone
765-1301 n
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
•
for
CONSTRUCTION or ALTERATION PERMIT .
SEPTIC TANK or CESSPOOL
•
Permit No.
•
Fee .$
DATE .JAA 5, 19t3
APPLICANT NAME: 'a-Rear e ,)0-.74-//
aA1/ / 6:-APPLICANT ADDRESS: '� Jori°/r Aj Gi) De/tea,
• /E—OG' PT /1/ Y 1/ 77F
SEPTIC Z-' ESSPOOL -
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
-A/i /.) 51 A/ L FA 4/L/ 7j1,4.)LL/ f
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ,eay
OWNER MAILING ADDRESS: P® 40X-
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X'• • /Ii, _.s��� � y A/, - Z?--7 r
OWNER PROPERTY ADDRESS: 4150e"/ f , re
e4/7"Ci-f Oq L/ N.Y
TELEPHONE NUMBER OF CONTACT• PERSON: 5/K -•7'/'/
TAX MAP NO. : Section //? Block OS- Lot
CROSS STREET: /Y 455,4L, Pc ,,rlr
BUILDING PERMIT NUMBER CROSS REFERENCE:_.
C5- am/
• l Signature o, ffcan /
RECEIVED BY: Ilk
-own Clerk's Office
DATE: //
a r Fr .t.i •!
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ELEVATIONS ARE REFERANCED TO N C V D ________________ ____
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
a'm•'�w"ou,', ....p. .-,-^• n•- FOR APPROVAL OF CONSTRUCTION ONLY
atan.lard.of Y•t"• ..✓^y•5•F'anm.nl /,': '2-.3
J
•r Health /C// n DATE• .- H S REF No I —---� I
LOT 1O2 fL�/ TI APPROVED =` - • 'l'..
COSTING 1V/0,/F --�— --"-
1k1. ROY A SCHttIDT
DWELLING
"L LOCATION OF WELLS AND CESSPOOLS SHOWS HEAECN ARE FRCM FIEU.
Jb.:ERVATONS ANC/OR LATA OBTAINED FROM OTHERS
S 86'33'00" E `
C
ESSPOOL
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` FRAME i_ •9"i ibf ';3 j !_ .ii:� i'!4: ! �i-1 i .1:f' :i'('• (, V ,E.. \ ` \ HOUSE ) I/-a,L nuuaawo.kwi,/N �� a 293. 15 i
\ CONC IM.fI _ tliJCK STIFFS = ,/. U (7 7 f
/ \ - -- I' SLATE 0.0'S 10 ` \ \ I0 3
' /-GMAGE.2 N I -"
•`� SLATE PUT
SLATE OZ'S 11 9'—_'
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3�4N I (I P2R I f L CARFORT� GARAGE I
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