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JUDITH T.TERRY ; ® Town Hall, 53095 Main Road
TOWN CLERK ,@0 g t P.O.Box 1179
REGISTRAR OF VITAL STATISTICS VO 't
►�1 Southold,New York 11971
MARRIAGE OFFICER �- � O C� �� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER : ®A $i ,so 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. 1261 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
INSTALLATION OF AN 8 X8 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 WITSCHKE, ROBERT
Mailing Address 1 10225 SOUNDVIEW AVENUE
City St Zip SOUTHOLD NY 11971
Property Address 1 10225 SOUNDVIEW AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 54.00 block 8 lot 7.000
Cross Street KENNY'S ROAD
Building Permit Number Cross Reference:
Issue Date: 12/12/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY t ® ,,,, v v'. og , Town Hall,53095 Main Road
TOWN CLERK ; 05 ,4 ,_ z a, % P.O.Box 1179
. �. °
a-to '0 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS 1.14
# @t Fax(516)765-1823
MARRIAGE OFFICER �® 1
RECORDS MANAGEMENT OFFICER : ®l ED VII, Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER ,f•"'
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OFFICE OF:THE TOWN CLERK DEC — 8 1994 , :,�`a
TOWN OF SOUTHOLD
TO: Southold Town Building Department
BLDO D FROM: Linda Cooper, Southold Town Clerk's Office TOWNOFSOUTf�OLD Ji
DATED: December 8, 1994
Transmitted herewith is a copy of application No. A 1307 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
- Gary Tabor for Robert Witschke .
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 followinginrecommendation:
-
APPROVE - 1------- ---
/ �����I®6� 81�PECT00
DISAPPROVE - REQ1RE®
COMMENTS: Maintain required setbacks from adjacent wells, •
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
'RECEIVED 41)
DEC 9 1994 Signatur:.-��
Ay
Town Clerk Southoldr p ". •
Date
•
C)FFICE OF THE TOWN CLERK c0FUL '
Town of Southold � • CSG
Judith T. Terry, Town Clerk - /Application No. v v 7
Town Hall, 53095 Main Road Construction
P. O. Box 1179
e:, • Alteration
Southold, New York 11971 �0��,
,y�
Telephone _0! , �9Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. •
Fee -$
DATE
APPLICANT NAME: 6tV /5/' �C
APPLICANT ADDRESS: & Y 1 1�/ C /.
i' I L.
SEPTIC CESSPOOL ,)/
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
i ciAf 11k7 fo D /.
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Q b r j ' ' 75
OWNER MAILING ADDRESS: /0 2 ,2,.5— S O vA/CI U ) ' e LU Jt/
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 3'I'3 -
TAX MAP NO. : Section �/ Block Lot 7
CROSS STREET: X/: r-t/ S l� '
BUILDING PERMIT NUMBER CROSS REFERENCE:'
Si ture of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
I D 2 - 5 o o 'e v .