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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK ® P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS (XS � Southold, New York 11971
MARRIAGE OFFICER tibkr Fax (516) 765-1823
®1 Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1060 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ELIZABETH THOMPSON, ARCHITECT
Address 1 : 270 LAFAYETTE ST., STE. 1303
City St Zip NEW YORK NY 10012
Descripton of Proposed Construction or Alteration
SEPTIC SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #93-50-44
Name Of Owner PREUSS, ARNOLD AND MARIA
Mailing Address 1 316 SCRANTON AVENUE
City St Zip LYNBROOKE NY 11563
Property Address 1 MAIN ROAD
City St Zip ORIENT NY 11957
Tax Map No. section 14.00 block 2 lot 30.003
Cross Street NARROW RIVER ROAD
Building Permit Number Cross Reference:
Issue Date: 11/10/93 Judith T. Terry
Southold Town Clerk
(TOWN SFAI
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e'',OF011ie.. .
JUDITH T. 'TERRYP�' .. 4"4I. Town Hall, 53095 Main Road
• ;' 'i t P.O. Box 1179TOWN CLERK cza •f
REGISTRAR OF VITAL STATISTICS ` VI y '' Southold, New York 11971
MARRIAGE OFFICER 110 = � Fax 516
.r=; : • ( ) 765-1823
�,�ost Bp �`����� Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK .
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: November 1, 1993
Transmitted herewith is a copy of application No. 1092 for a Cesspool/ •
Septic Tank Construction Permit submitted by:
Elizabeth Thompson for Arnold and Maria Preuss .
Please review the application and location map and advise if the nrp`roject--
has received Suffolk County Health Department approval and if tis office T'
may issue the permit.
i:i:-
Please complete the form below and return it to me. t ��, '
Thank you. s '
•Linda J. Cooper ,E� ,pc� - -- ref,
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE Il �
DISAPPROVE
Comments: deer .„.moi. cc'. d 1./, 9 3 S o — 1-4 .
Nov ism Signatur .:
/7/ 1/ 93
Ind MR roti fott Dated
OFFICE OF THE TO,,'N CLERK . Oc,�rF�(2- -'
Town of Southold Y,
Judith T. Terry, Town Clerk ..,,,,-;„1.::•.7:::.?,,, Oy
,.r- ._ Application No. 097
Town Hall, 53095 Main Road � r=• `1""^ '- -�>~
P. O. Box 1 179 �' /'�•; Ffti: .r=-fi Construction v`^'Southold, New York 11971 n
O "a'
�� Alteration
Telephone "et . �b f� Residential L/
(516) 765- 1301 • v
iii,
Non-Residential_____.
TOWN OF SOUTHOLD
•
• SOUTHOLD WASTEWATER DISPOSAL, DISTRICT
•
•
APPLICATION
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for li'lircalT7P7, 77.77:Z:1
`11 , ,
CONSTRUCTION or ALTERATION PERMIT 0rNOV 99'
SEPTIC TANK or CESS" A
SPOOL LwO'oe,,i CL `
Permit No.
Fee $ 10 . 60 .
DATE 1,0 ZS- ei
APPLICANT NAME:
lit E. `T - -Sok) 41Z-C..,14-1, -
APPLICANT ADDRESS: £7o LAFA -
SEPTIC X 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: A,�Nbr_,t) i Mil PR-F ,
uss
• OWNER MAILING ADDRESS: 3Ib SGeA.k)
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tiB L 115
•
OWNER PROPERTY ADDRESS:
•
PSR( ,t_9 .
•
TELEPHONE NUMBER OF CONTACT PERSON: 21Z -27
TAX MAP NO. : Section fid}• • Block Lo
t 30. •3
CROSS STREET: M fee-,A-b.
BUILDING PERMIT NUMBER CROSS REFERENCE:..
Di ¼
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• Signature of Appli ant -
RECEIVED Bo _
V.-4*A Clerk's Office
DATE: Tam Cie. •
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