HomeMy WebLinkAboutMehrman •
OFFICE OF THE TOWN CLERK c�FFULA
Town of Southold 0�� 4.%
Judith
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. O. Box 1179 •. f '
Southold, New York 11971Ol sF••.••
Telephone
(516) 765-1801 //
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 306 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: John R. Mehrman
ADDRESS: 83 Circuit Road
Bellport, New York 11713
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION New Single Family
Dweling with Sanitary System.
APPROVED as indicated on Suffolk County Health- Department survey.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: John R. Mehrman
OWNER MAILING ADDRESS: 83 Circuit Road
Bellport, New York 11713
OWNER PROPERTY ADDRESS : 3210 Wells Road
Peconic, New York 11958
TAX MAP NO. : Section 86 Block 1 Lot 10.2
CROSS STREET: Route 25
BUILDING PERMIT NUMBER CROSS REFERENCE:
Judith T. Te 'y
Southold Town Clerk
DATE : March 15. 1988
(TOWN SEAL)
•
ULIV
r ` "<<'``y� i�` Town Hall, 53095 Main Road
- P.O.,Box 1179
•
�- ,.<<£; 1,., 1,• Southold, New York 11971
JUDITH T.TERRY �� � z
�- TELEPHONE
1OWN CLERK (516) 765-1801
REGISTRAR 01 VITAL S fATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
March 15, 1988
John R. Mehrman
83 Circuit Road
Bellport, New York 11713
Re: 3210 Wells Road
Peconic, New York 11958
Dear Mr. Mehrman:
Enclosed herewith is the Construction, Alteration or Modification
Permit for a Septic Tank or Cesspool System for which you applied.
Please be advised that each owner of real property operating an
on-site sewage disposal system, such as a septic tank or cesspool must,
prior to such operation, possess in the name of the owner -an Operation
Permit for the system. The Operation Permit is issued by the Town
Clerk's Office.
The fee for an Operation Permit is ten dollars ($10.00) for
residential use and twenty-five dollars ($25. 00) for non-residential. _
'Please have the owner complete the enclosed Application for an Operation
Permit and return it to this office along with the proper fee. - -
For your -general - information I have enclosed an Informational
Bulletin regarding the Scavenger Waste Laws; adopted by the Southold
Town Board. Should you have any questions pertaining to either permits
or the Scavenger Waste Laws, please do not hesitate to contact this
office. We will be glad `to assist you in any way possible.
Very truly ?fours,
famori him/
Judith T. Terry
Southold Town Clerk
Enclosures (3)
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` � z7r� Town Hall, 53095 Main Road
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' '({y P.O. Box 728
_, , , , '\ ; Southold, New York 11971
JUDITH T TERRY TELEPHONE
TowN CLf;RI: (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
March 11, 1988
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 310 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by John R. Mehrman
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
.4,,- rte.
Judith T. Terry
Southold Town Clerk
* * * * * * * * *
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE - )(
DISAPPROVE -
COMMENTS: q„ A,,,,.,PQd'c_, A c.
%.,1A,U...2.41
\C:c....,ru.A. C:1).A..2,...2 a..4.41--
Signature
Date
L
OFFICE OF THE TOWN CLERK v FDLY4
Town of Southold �/ Application No.sa l D
Judith T. Terry, Town Clerk .0
Town Hall 53095 Main Road c 41.k Construction 1.,/-
P.
P. O. Box 1179 p T.qt, Alteration
Southold, New York 11971 .,
Tele hone Ol Residential
p
(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 $ /Z), D U
DATE 3 /i//S'
APPLICANT NAME:
APPLICANT ADDRESS: Cg G. f_A
SEPTIC \ CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION (L_„ .�
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION :
OWNER OF PROPERTY: � \ 2,,
OWNER MAILING ADDRESS: c
OWNER PROPERTY ADDRESS: ?�A,t.)
TELEPHONE NUMBER OF CONTACT PERSON: a_ g6--ktu1/4-557
TAX MAP NO. : Section �b Block U I Lot /e-).-D---
CROSS
ej. -
CROSS STREET: '"Z d-S
BUILDING PERMIT NUMBER CROSS REFERENCE:
•
Signature o Applicant
RECEIVED BY: I,I` !
own erk • Office
DATE: / t
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- „ - SUFF.CO. DEPT.OF HEALTH SERVICES - STATEMENT OF INTENT: -
- -. TEST H01.4'
,:1,.1,' SINGLE FAMILY DWELL1NQ QNL,Y •
r ---: FOR APPROVAL OF CONSTRUCTION ONLY- . . .r.• _ -`
:“-4;- _ • THE WATER SUPPLY AND SEWAGE
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4 SCOW, DATE: s` ✓—��,B 1 ▪ - --DISPOSAL SYSTEMS FOR THIS REST.'-.
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, DENGE' WILL. CONFORM' TO` THE
9 H.S. REF. NO.: �� D ! ' - - STANDARDS OF SUFFOLK CO. DEPT.'.
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