HomeMy WebLinkAboutSchubeck JUDITH T.TERRY ; ® Town Hall,53095 Main Road
TOWN CLERK g P.O.Box 1179
REGISTRAR OF VITAL STATISTICS 0O Southold,New York 11971
MARRIAGE OFFICER �, ®� .1� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER � ED 4u\opel Fax
(516)765-1800
FREEDOM OF INFORMATION OFFICER ••�•�„ ,,•S'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1205 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW CESSPOOL 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 SCHUBECK, BARBARA
Mailing Address 1 800 WEST CREEK AVENUE
City St Zip CUTCHOGUE NY 11935
Property Address 1 800 WEST CREEK AVENUE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 103.00 block 13 lot 6.000
Cross Street OLD PASTURE ROAD
Building Permit Number Cross Reference:
Issue Date: 9/15/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
, ce glik'
,00,0, ,,,,, /0) 0 __S----
c 1/11 ® _
%
JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS =® Southold, New York 11971
MARRIAGE OFFICER � fir, Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER ®1 i� Telephone (516) 765-1801
FREEDOM OF INFORMATION OFFICER —.. .,,ralli•• _
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: September 8, 1994
Transmitted herewith is a copy of application No. A1250 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Barbara Schubeck .
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 followingwrecommendation:
APPROVE - v
s -kVAT1ON INSPECTION
DISAPPROVE -
COMMENTS: ,,,,� `� • `: .9 9°
' / s�) g",.647 ,
/07)1
eV ku'07 ---.,- ,,,,--„,-,:f,,, -,,,•,,L -
,
Sic.natur-. 0
%
Date
I
OFFICE OF THE TOWN CLERK ,,•"•••••�••.
Town of Southold e� '��c�� f011(4, _
Judith T. Terry, Town Clerk �� O OGy Application
Town Hall 53095 Main Road `
P. O. Box 1179 � Construction
. .;i. aC
Alteration
1 ::
Southold, New York 11971 tt3 �� /
Tele hone ; O Q� `� $10.00 - Residential t/
p
(516) 765-1801 X4/1 44 1' 'e $25.00 - Non-Residential
. ,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee •$ n
DATE „5/c----/,( F �P c/
APPLICANT NAME: e.a4? ,may t
APPLICANT ADDRESS: 27� �/� ���7� ‹
SEPTIC CESSPOOL
DESCRIPTION OF PR•POSED CONSTRUCTI.N OR ALTERATION
LOCATION MAP: • Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTIONR ALTERATION :
OF PROPERTY: / ����42 t��y/G�,-Cc
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: /9 Gc,/CC'S' , 1-
TAX MAP NO. : Section MS Block Lot
CROSS STREET: 6,1_,6 /3a,..421-
BUILDING
-BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY:
To n C erk's Office •
DATE: •
er- •
, • 1
25
l
` S
SSS ��