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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK ® r T P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
,� Fax (516) 765-1823
MARRIAGE OFFICER
_tr® % 1r Telephone (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. 694 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : RICHARD MOHRING
Address 1 : 323 GLEN COVE AVENUE
City St Zip SEA CLIFF NY 11579
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 1/25/91 .
Name Of Owner MOHRING ENTERPRISES
Mailing Address 1 323 GLEN COVE AVENUE
City St Zip SEA CLIFF NY 11579
Property Address 1 LAUREL AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 56.00 block 1 lot 0U .,2.
Cross Street YENNECOTT DRIVE
Building Permit Number Cross Reference:
Issue Date: 4/01/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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• TOWN OF SO E veZE_Ee ,t`:''' .4:7-t :'`.::,;''s P.O. Box 1179
�`=0/ ,-1., , ;may 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: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office
Dated: March 15, 1991
Transmitted herewith is a copy of application No. 712 for a Cesspool/
Septic Tank Construction Permit submitted by:
R. Mohring for Mohring Enterprises Inc
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 -
DISAPPROVE
Comments: at, �� QQ, 0. -cam
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Signature
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Dated
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OFFICE OF THE TOWN CLERK ,i" '
Town of Southold
eJ �0
Judith T. Terry, Town Clerk ,� O ��' Application No. fl
Town Hall, 53095 Main Road Construction i
P. O. Box 1179 =v rn Alteration
Southold, New York 11971
Telephone ;Vg, $10.00 - Residential 4-"''
(516) 765-1801 _ ?ijilt �O,
$25.00 -Non-Residential
+ --.1.(10
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE -7/ (17
APPLICANT NAME: P/G f//?,tGtJoj
APPLICANT ADDRESS: 3� 3 C(Q 4-, Cat- 9 u
Sc- C < <q' 4 ( (i // c 7
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: It c70 a t--
OWNER
OWNER MAILING ADDRESS: 3 2 ( C 0 u, ( v
OWNER PROPERTY ADDRESS: C t
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section r.c Block ) Lot � `"?` l
CROSS STREET: C Ct ek CJ t
BUILDING PERMIT NUMBER CROSS REFERENCE:
1.
/4
igna ure of Applicant
RECEIVED BY: ( [ h R C C U V R O
Tow Clerk's Office
DATE: AR L 5 $991i
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`IENNECIE ` I, .
- ORwE ', „t ... ,
SURVEY FOR . ,
• - MOHRING ENTERPRISES,INC. ` '
,u01-4.-Lf. LIiUI.IY DEPARTµENT .OF HEALTH SERVICESLOT NO 25,II LONG POND ESTATES,SECTION TWO" _
- AT ARSHAMOMAQUE- DATE NOV 29,1990
FOR APPROVAL OF CONSTRUCTION ONLY TOWN OF,SOUTHOLD I' SCALE 1 =50'
L� SUFFOLK COUNTY, NEW YORK NO 90-0951
°ATE T 25,1991 . REF. NO �)O '
%uNAUTHON12ED ALTERATION OR ADDITION TO THIS OF N w
leb / SURVEY ESA VIOLATION OF SECTION 7209 OF THE . It. NE
4,
" NEW YORK STATE EDUCATION LAW -StP yp
M COPIES OF THIS SURVEY NOT SEARMG THE LAND
APPROVEDRA I 5 �' SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL y�PRO W. y 9¢
7 D Jas NOT SE CONSIDERED TO BE A VALID.TRUE COPY Q 0G
7 %GUARANTEES INDICATED HEREON SHALL RUN bILY TO .Z`
HEALTH DEPARTMENT-DATA FORlAPP-ON4L TO CONSTRUCT ND, THE PERSON FOR WHOM THE ITLE C Is NY,PREGO ED 'F ", yO
AND OH HIS BEHALF TO THE TITLE COMPANY,GOVERN- �S y
•NEAREST WATER ■AIN_rl _ MSOURC OF WATER PRIWITE_PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED _�/71y T
N NOP CO TAX NAP DIST 1000 SECTION-3$_SLOCK_L_LOT 9/431 HEREON,AND TO NE ASSIGNEES OF THE LENDING
NTHERE ARE ISD DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION GUARANTEES ARE NOT TRANSFERABLE
TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
OTHER THAN THOSE SHOWN HEREON OWNERS !, 4' .;g3
M WILL
WATER TO YTi AAD SEWAGE DISPOSAL SYSTEM CO THIS OI Ma M DISTANCES SHOWN HEREON FROM PROPERTY LINES '5/
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TO ESIS TINS SThu C TURES ARE FOR A SPECIFIC 4's • 0 a
Of NEALTN SERVICES PURPOSE AMD ARE NOT TO BE USED TO ESTABLISH 0 LINO Su E
APPLICANT. PROPERTY LINES OR FOR THE ERECTION OF FENCES '
ADDRESS . .
•
TEL A,YOUNG al YOUNG RRIIV°ERHEAD,NEW YORK
OSTRANDER E
NOTE•• ALDEN W YOUNG,PROFESSIONAL ENGINEER
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF AND LAND SURVEYOR N YS LICENSE NO 12B4S
SUFFOLK COUNTY ON NOV.29,1990 AS FILE NO 9031. • .
en ' HOWARD W YOUNG, LAND SURVEYOR --
m N THE LOCATIDN OF WELLIWI,SEPTIC TANKISTIS CESSPOOLSIC►1 SOWN NUMMI , N Y S LICENSE NO 45893
ARE FROM FIELD OSALR' TIONS AMD OR DATA°BTANED FROM OTHERS
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'SRANDIS A SONS INC - - ,