HomeMy WebLinkAboutGarcia, Richard ,,,'��/O�OS�FF0��1 nO
• JUDITH T.TERRY ��c ' Town Hall,53095 Main Road
TOWN CLERK H Z ; P.O.Box 1179
Pri
'� Southold,New York 11971
REGISTRAR OF VITAL STATISTICS %, _%.!
4 �1 Fax(516)765-1823
MARRIAGE OFFICER ;_�I0 �0 ��
RECORDS MANAGEMENT OFFICER 1 J .� Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER �
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1421 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 AN 8 X 8 LEACHING 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 GARCIA, RICHARD
Mailing Address 1 505 BAYER ROAD
City St Zip MATTITUCK NY 11952
Property Address 1 505 BAYER ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 139.00 block 3 lot 13.000
Cross Street CONKLIN ROAD
Building Permit Number Cross Reference:
Issue Date: 12/07/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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r 3UDI T.TERRY �4 y� Town Hall, 53095 Main Road
TOWN CLERK ; co) Z P.O. Box 1179
Prr $ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS :.� *. Fax (516) 765-1823
MARRIAGE OFFICER = � _,%N• ifs
Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER 1 Alp
FREEDOM OF INFORMATION OFFICER s
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: November 27, 1995
Transmitted herewith is a copy of application No. A1476 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Gary Tabor for Richard Garzia
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. �q t
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.
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Signatur
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Date f
OFF..ICE OF THE TOWN CLERK ""
Town of Southold ,lostf ilLxt+
Judith T.'Terry, Town Clerk ;' Application No./' 7,
Town Hall, 53095 Main Road ;� = Construction
P. O. Box 1179
Southold, New York 11971t�t1 Alteration
Telephone = ,� ��' $10.00 - Residential
(516) 765-1801 = �1 �, �'� $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ it)
DATE 7/ � 7/I 9 c5f
APPLICANT NAME: Cc. ," „I' 2 4 "—
APPLICANT ADDRESS: n s'O 1,3419Y til
SEPTIC CESSPOOL Lam'
DESCRIPTION OF PROPOSED CONSTRUC"T"ION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 177 '(--.),,,5777C& 7�-.42-7 ,'/43
OWNER MAILING ADDRESS: QS )7,9;/er 1?cJ
OWNER PROPERTY ADDRESS: S2./,7,-t
TELEPHONE NUMBER OF CONTACT PERSON: 373 _
TAX MAP NO. : Section ) 3 ? Block 3 Lot 3
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Wture of Applicant
RECEIVED BY: RECEIVED
Town Clerk's Office
DATE: NOV 2 7 1995
Town Clerk SOlthold
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