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JUDITH T.TERRY ` b �� Town Hall,53095 Main Road
TOWN CLERK t g P.O.Box 1179
Priv t
REGISTRAR OF VITAL STATISTICS %`' 0 1, Southold,New York 11971
MARRIAGE OFFICER ®� '1 Fax(516)765-1823
RECORDS MANAGEMENT OFFICER = ell ED Vol Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER . ,gia
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1384 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : GARY TABOR
Address 1 : 680 NAVY STREET
City St Zip ORIENT NY 11957
Descripton of Proposed Construction or Alteration
ADDITION OF 8 X 10 POOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION
INSPECTION REQUIRED.
Name Of Owner MINOR, REGINALD
Mailing Address 1 P. O. BOX 68
City St Zip ORIENT NY 11957
Property Address 1 360 STEVENSON RD.
City St Zip ORIENT NY 11957
Tax Map No. section 17.00 block 1 lot 12.000
Cross Street ROUTE 25
Building Permit Number Cross Reference:
Issue Date: 9/11/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
` % ?
JUDITH T.TERRY ® . % Town Hall,53095 Main Road
TOWN CLERK t cg g , P.O.Box 1179
REGISTRAR OF VITAL STATISTICS %%''
O ,' 0 Southold,New York 11971
MARRIAGE OFFICER =V J®�'�i�� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER Vo n
Telephone,(516)765-1800
FREEDOM OF INFORMATION OFFICER •1
SEP - 61999 i; :
OFFICE OF THE TOWN CLERK . r
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TOWN OF SOUTHOLD =i a:
TO: Southold Town Building Department e - = - -_-- - ;-k __,_
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: September 6, 1995
Transmitted herewith is a copy of application No. ; 1436 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Gary Tabor for Reginald Minor .
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 -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
,P,
Signature ir
11/6;//9.
Date ���4////
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OFFICE OF THE TOWN CLERK �,R 'r'"""'
Town of Southold ��V(11. Application No.
Judith T. Terry, Town Clerk � ® r ; � �r� r�
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Town Hall, 53095 Main Road 3 ,; ; - Construction_ �.
P. 0. Box 1179 " ' ' ✓
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Southold, New York 11971 s�'9 f'`'` �S; , ''r.' . Alteration—
Telephone
lteration—Telephone $10.00 - Residential_
(516) 765-1801 "K 1 *6,0'
$25.00 - Non-Resi j
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE Y/`5 /?'-S
APPLICANT NAME: 6 ,97, v
AOe,
APPLICANT ACDRESS': •
0Prr6
CESSPOOL -
�<<.�cl OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attacked hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ATERATION:
OWNER OF PROPERTY : r_e__7 /1/17 /c/. 7 ', O r-
OWNER MAILING ADDRESS: p o_ G6' " / e9?
OWNER PROPERTY ADDRESS: j-CP 0 5 / e- [J e W5 o, S )�
TELEPHONE NUMBER OF CONTACT PERSON: (5, j - 2- Co
TAX MAP NO. : Section /7 Block / Lot AR
CROSS STREET: )( C9 / -S�
BUILDING PERMIT NUMBER CROSS REFERENCE:
cz nature of Applicant
RECEIVED BY : vv
/own CerOffice
DATE:
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