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JUDITH T. TERRY %� T j Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS a Southold, New York 11971
MARRIAGE OFFICER `ter r �� Fax (516) 765-1823
tgP . � Fax
(516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 706 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MOHRING & SONS
Address 1 : 323 GLEN COVE AVENUE
City St Zip SEA CLIFF NY 11579
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 ON 4/23/91 .
Name Of Owner MOHRING & SONS
Mailing Address 1 323 GLEN COVE AVENUE
City St Zip SEA CLIFF NY 11579
Property Address 1 LAUREL AVENUE
(LOT 33)
City St Zip SOUTHOLD / NY 11971
Tax Map No. section 56.00 block 1 lot 2.001
, Cross Street POND AVENUE
Building Permit Number Cross Reference:
Issue Date: 5/08/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY = ;,,, ,�;;-- TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR 01-VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office
Dated: May 2, 1991
Transmitted herewith is a copy of application No. 725 for a Cesspool/
Septic Tank Construction Permit submitted by:
Mohrinq & Sons
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
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OFFICE OF THE TOWN CLERK ,'""'"''--
Town of Southold
CO' I(
Application No. ��cfy�
Judith T. Terry, Town Clerk /O' ® G
Town H�II, 5305 Main Road Construction
P. O. Box 1179 ; = z :
Southold, New York 11971 ; r,j Alteration
Telephone =�O,y� $10.00 - Residential L
(516) 765-1801 : ®1 �, o' $25.00 - Non-Residential
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
MAY 21991
Permit No. Itaum Cie*
Fee $ /
DATE f/ (c/
APPLICANT NAME: (O /2/J 6 -7 fb Gt 'f
APPLICANT ADDRESS: 3g 3 ((c
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SEPTIC ( CESSPOOL V
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION ,3,-N6-- C
((L) cl ( t` KG/
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ti-1,6 1-1 124- .1ct" `s
OWNER MAILING ADDRESS: :?2'.3 C(-c'i CO u p u p
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OWNER PROPERTY ADDRESS: L- c( C1 /� 0'
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TELEPHONE NUMBER OF CONTACT PERSON: C F J
TAX MAP NO. : Section Block Lot .
CROSS STREET: po GI PO' t
BUILDING PERMIT NUMBER CROSS REFERENCE:
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Signat re of Applicant
RECEIVED BY: W �
own Clerk's Office
DATE: 317_ �rt
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SINGLE FAMILY DWELLING ONLY :
. ' EXPIRES TWO YEARS FROM DATE OF APPROMN! ,
SURVEY FOR
- MOHRING ENTERPRISES, INC. ,
iUFFOLK COUNTY DEPARTMENT Of HEALTH SERVILE. LOT NO 33, "LONG POND.ESTATES,SECTION TWO" ,
- AT ARSHAMOMAQUE - DATE MAR 22, 1991
FOR APPROVAL OF CONSTRUCTION ONLY TOWN OF SOUTHOLD , SCALE I.._ 50' ,
S a� SUFFOLK COUNTY, NEW YORK NO 91 - 0219
DATE R 23 . . S REF. NO *UNAUTHORIZED ALTERATION OR ADDITION TO THIS -
V SURVEY 8 A VIOLATION OF SECTION 7205 CI THE
--�// NEW TORR STATE EDUCATION LAW TE OF N
_J/��/ .? -°6.1'''\_,_ •COPIES OP MIS SURVEY NOT BLARING THE LAND SSP ,,,
�P°oOVFD Ii- 'I%¢ �f� SURVEYOR'S INKED UAL OR EMBOSSED SEAL SHALL 'Q
3 e S S )STD _ / :Lc _�I NOT BE CONSIDERED TO BE A VALI O TRUE COPY PRD w �, 9,1,
"1 / INDICATED HEREON SHALL RUN ONLY 10
HEALTH DEPARTMENT-DATA FOR APPROWL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED If ,ZO OG
AND ON HIS BEHALF TD THE TITLE COMPANY,GOVERN
M WATG RAIN MI . II SOURCE CF WATER PRIVATE_PUSLIC- MENTAL AGENCY AND LENDING INSTITUTION LISTED kt, O
I PUFF CO TAG MAP DHT LQQQ SECTION_SSL BLOCK-A_LOT P/021 HEREON,AND TO THE ASSIGNEES OF THE LENDING ;
R MERE ARE NO MILLIONS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION GUARANTEES ARE NOT THAN
OTHER THAN THOSE SHOWN HEREON TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
■THE INTER SUPPLY AND IMAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS
•DISTANCES SHOWN HEREON /ROM PROPERTY LINES ./ 0
WILL CONFORM TO TN STANDARDS OF THE SUF/OLB COUNTY /• 95893
TO LEIS TINS STRUCTURES ARE FOR A SPECIFIC
OP
MTH SERVICES PURPOSE AND ARE NOT TO BE USED TO ESTABLISHAPPLId - OR'
- PROPERTY LINES OR FOR THE ERECTION OF FENCES T. 4(ARD g,I VE'1
ADDIIL1 -
TEL YOUNG a YOUNG - DRHE' , wroR E .
NOTE- ALDEN W YOUNG,PROFESSIONAL ENGINEER -
SUBDIVISION MAP FILEDTHE OFFICE THE CLERK
I OF SUFFOLK COUNTYTYONN NOV 29,1990 A AS FILE NOO 9031 AND LAND SURVEYOR N Y.S LICENSE NO 12845
HOWARD W YOUNG, LAND SURVEYOR -
R ne LOCAnMI a VC L(W),SEPTIC TANE(ST)S CESSPODu(DII SHOWN IMRLOM N Y S.LICENSE NO 45893 ,
AIME PROM FIELD OOLRIMTIOHS NC OR DATA OBTAINED FROM OTHERS
1
BRARDIS L SONS INC. - -