HomeMy WebLinkAboutScholl (2) 400:00v =
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Town Hall, 53095 Main Road
"0) ` P.O. Box 1179
Southold, New York 11971
JUDITH T.TERRY � r'��' 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. 462 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : SCHOLL, WILLIAM P. JR.
Address 1 : 1260 BUNGALOW LANE
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.
Name Of Owner SCHOLL, WILLIAM JR.
Mailing Address 1 1260 BUNGALOW LANE
City St Zip MATTITUCK NY 11952
Property Address 1 CENTER STREET
City St Zip MATTITUCK NY 11952
Tax Map No. section 123.00 block 2 lot 18.000
Cross Street BUNGALOW LANE
Building Permit Number Cross Reference:
Issue Date: 2/09/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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TOWN OF SOUTHOLD OLD tri � I r=
,� ,� : . Town Hall, 53095 Main Road
•� P.O. Box 1179
_ 1 1,��.i••
Southold, New York 11971
JUDITH T.TERRY �� TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office
Dated: February 8, 1989
Transmitted herewith is a copy of application No. 471 for a Cesspool/
Septic Tank Construction Permit submitted by:
William P. Scholl Jr.
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.
Linda J. Cooper
* * * * * * * * * * * *
I
have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE X
DISAPPROVE _
Comments: AL c c _Lc to cL c
43.4, C
Signature
-,'�
Dated
•
OFFICE OF THE TOWN CLERK O�jUrDL�{�D
Town of Southold o0� _
Judith T. Terry, Town Clerk F; _ Application No. 1
G7 �rY .. h_ L
Town Hall, 53095 Main Road cry ,� Construction
P. O. Box 1179
Southold, New York 11971 Alteration
Telephone oI + Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
f
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 117
Fee $ Jar --i
DATE
APPLICANT NAME: /' 1 g C I/oLL, ✓R
APPLICANT ADDRESS: /zta 430tvCPi- ow SCA
/ ?'T/TUc/C NY.
SEPTIC / CESSPOOL /
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
14&
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: bin Ste' C/-/o LAd R.
OWNER MAILING ADDRESS: /2 to EL/4/ f. k)/ oa.4) 1.14
/7 0- 7 T /mac) c. rc AIL/ // ,r-'%,
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 2, - fe/r6
TAX MAP NO. : Section /3-3 Block 02 Lot /
CROSS STREET: 73vi✓4is1-ow AAA/6"
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: 4/4--
Town Clerk's Office
DATE: o2./151f5p
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ANN KNUDSEN l`Pi AREA = 17,475s1
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ELEI VS ARE REFERENCED TO
_ I ' - ASS DA Tat
7LWTY DEPARTMENT OF HEALTH SERVICES
41,ROVAL OF CONSTRUCTION owe ,p17•rrd.e •msp®Ea!
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TM locations o/wells and wrspoolr shown berwn ar.from 1N Title As*cJ
obserrallonr and or lrom da/a lamed From o/Mrr. ?"ri/C/r ,/✓,-:/, 11952
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