HomeMy WebLinkAboutGerdts, Robert D %
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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK : =v T % P.O. Box 1179
� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = VO �„ *'� Fax (516) 765-1823
MARRIAGE OFFICER ==.,'`^ ��) ,$ Fax
(516) 765-1801
RECORDS MANAGEMENT OFFICER 1 .°
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. 1066 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ROBERT H. GERDTS
Address 1 : P. O. BOX 184
City St Zip LAUREL NY 11948
Descripton of Proposed Construction or Alteration
REPLACE OVERFLOW CESSPOOL AND ADDITION OF CESSPOOL TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, AND PROPERTY LINES. EXCAVATION INSPECTION REQUIRED.
Name Of Owner GERDTS, ROBERT & KATHLEEN
Mailing Address 1 P. O. BOX 1814
City St Zip LAUREL NY 11948
Property Address 1 225 FRANKLINVILLE ROAD
City St Zip LAUREL NY 11948
Tax Map No. section 125.00 block 1 lot 3.000
Cross Street ALDRICH LANE
Building Permit Number Cross Reference:
Issue Date: 12/01/93 Judith T. Terry
Southold Town Clerk
-- -_ (TOWN SEAL)
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JUDITH T. TERRY z ` : Town Hall, 53095 Main Road
TOWN CLERK : v T P.O. BOX 1 179
REGISTRAR OF VITAL STATISTICS �` ,� Southold, New York 11971
MARRIAOL OFFICER ‘°404.4.. O� .�' Fax (516) 765-1823
�,`j� Alt �1D •� Telephone (516) 765-1801
•
5 OFFICE OF THE TOWN CLERK
," TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: November 15, 1993
•
Transmitted herewith is a copy of application No. Al099 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Robert & Kathleen Gerdts .
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.
. -1----7-a,,,._--,
Linda [y_
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - �---
DISAPPROVE - EXCAVATION INSPECTION
RE 1 UIRED
COMMENTS: '
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414.4044,
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Date
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OFFICE OF THE TOWN CLERK ,.,'""""'- /
Town of Southold �'' C�FFg[K�+e Application No )
Judith T. Terry, Town Clerk ;' �� Gy
Town Hall, 53095 Main Road ;$� Construction
P. O. Box 1179 ; =v rn
Alteration
Southold, New York 11971 $
Telephone $10.00 - Residential
(516) 765-1801 .,/ 4g �, $25.00 - Non-Residential
• ... �,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ 10'
DATE '13 k)O J 11 aea (461'3
APPLICANT NAME: "Fusea-c- 14 A k rt-4LEEk K (-4E- 1:513
APPLICANT ADDRESS: � 15Q)C t 4
Lnoa L- ( jU (44-g
SEPTIC CESSPOOL I
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Oki R RIAA.5 C£- L.. eP ni ekr-r A'bb rrt om3A
rpt
** LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ---RpRee N t k grr 4-1 LeeQ V 6 '��
OWNER MAILING ADDRESS: —RDx (. 4..
L4UVLI (1q4€
OWNER PROPERTY ADDRESS: a-a-rj FIQA k)11..UQvILt.
TELEPHONE NUMBER OF CONTACT PERSON: Lga-aorja, 4 a48-- '7
TAX MAP NO. : Section ja.5 j35Block Lot
CROSS STREET: ALS IZtC.H Laki
BUILDING PERMIT NUMBER CROSS REFERENCE: kdit
62_0-&-cl, AtitAnt4—
Signature of Applicant
RECEIVED BY:
tiro/0 Clerk's Office
DATE:
Town CM bail
**Location Map must show existing system and proposed placement of any additions or
alterations. Also show location of well and buildings located on property
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