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ELIZABETH A.NEVILLE et �°�� Town Hall, 53095 Main Road
TOWN CLERK ; 4:*
P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER 4' ��g11, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � �®1 %too Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ��'�
OFFICE OF THE TOWN CLERK
SOUTHOLD `WCASR RTEISIESSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2624 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ROBERT SCHUR
Address 1 : 8310 SOUNDVIEW AVENUE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
REPLACEMENT OF EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner SCHUR, ROBERT
Mailing Address 1 8310 SOUNDVIEW AVENUE
City St Zip SOUTHOLD NY 11971
Property Address 1 8310 SOUNDVIEW AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 59.00 block 7 lot 29.006
Cross Street KENNY'S ROAD
Building Permit Number Cross Reference:
Issue Date: 8/08/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
��,%SuffO /fe7 (0
e. •
ELIZABETH A.NEVILLE 1X; Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. ltox 1179
REGISTRAR OF VITAL STATISTICS Pr, I Southold, New York 11971
MARRIAGE OFFICER 44
($)° �I', Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER =_ l iii Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER - ����
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 18, 2001
Transmitted herewith is a copy of application No. 2710 for a Cesspool/Septic Tank Construction
Permit submitted by:
Robert Schur -
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE ✓
DISAPPROVE
Comments:
ignature
Dated
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OFFICE OF THE TOWN CLERK 111 vFFUL ti
TOWN OF SOUTHOLD ,�••Qr"J �1�'Q� Application Nog
ELIZABETH A.NEVILLE,TOWN CLERK i 0
P.O.BOX 1179 Z Construction'
SOUTHOLD,NEW YORK 11971 : p • ..T ; Alteration
Telephone �,��0 0Qi� $10.00 -Residential
I.
(631) 765 1800 - 1 - ,,�"' $25.00 -Non-Residential
- -,,,,.
TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION •
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. -
Fee .$
DATE 7//r/d f
APPLICANT NAME: R/le.1,-ty-.APPLICANT ADDRESS:
Sal D v/e-�✓ /.}-,rz .
—� � . 1 AN 1
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
L _-
I ____.... j
r_WA. -112MAMI_-_-_MIM
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: -
• OWNER OF PROPERTY: --Ca-014e- a.r r-u-e_.
OWNER MAILING ADDRESS:
k / r ,i
OWNER PROPERTY ADDRESS: /t // /I
TELEPHONE NUMBER OF CONTACT PERSON: C.�•,3/) 74„r-_3:,. .e7
TAX MAP NO. : Section Block 7 Lot o2 9, 4
CROSS STREET: `7,k,e- 1 f i(•,'d •
BUILDING PERMIT NUMBER CROSS REFERENCE:
404i i' . ,
. -Signature o`i Applicant
RECEIVED B' j;� �: •
own Clerk's Office
DATE: v ' 6
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