HomeMy WebLinkAboutShowalter v, ���•i®SVFfO`tec®
ELIZABETH A.NEVILLE ,�����# G1 Town Hall, 53095 Main Road
TOWN CLERKripd P.O. Box 1179
y- nay Southold, New York 11971
REGISTRAR OF VITAL STATISTICS "‘ ®y ����', Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER _�Q1 $ ,,' Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER -- ��'� southoldtown.northfork.net
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OFFICETOF THETOWNCLERK
SOUTHOLD WAS WATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL,
Permit No. 2900 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : CHRISTOPHER SHOWALTER
Address 1 : 445 PEQUASH AVENUE
City St Zip CUTCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-02-0054
Name Of Owner SHOWALTER, CHRISTOPHER
Mailing Address 1 445 PEQUASH AVENUE
City St Zip CUTCHOGUE NY 11935
Property Address 1 1015 ORCHARD LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 90.00 block 4 lot 15.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 10/30/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE �� .Z.O OG :
TOWN CLERK ,i , : y.2 Town Hall, 53095 Main Road
o P.O. Box 1179
REGISTRAR OF VITAL-STPiISTICS v' Z i Southold, New York 11971
MARRIAGE OFFIGrrE''R�l Fax RECORDSMANAGEMF
`oy ������ Fax (631) 765-6145
FREEDOM OF INFOR1%ANT OFFICER ;�Ql ��®�i� Telephone (631) 765-1800vIATION OFFICER /I���,��,' southoldtown.northfork.net
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD 17-7-,---_— ----
TO: Southold Town Building Department p' i1 ` SFp
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FROM: Linda J. Cooper, Southold Town Clerk's Office f "- •-_
DATED: September 17, 2002 � �```--- ,
Transmitted herewith is a copy of application No. 3013 for a Cesspool/Septic Tank Construction
Permit submitted by:
Christopher Showalter
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: -
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Signature '
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Dated
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OFFICE OF THE TOWN CLERK •''�S�FFOLkt'
TOWNOFSOUTHOLD .•' Oy Application No.-10(3
FT.T7ABETH A.NEVIT.T-F,TOWN CLERK i O
P.O.BOX 1179 ` ; ' Construction
SOUTHOLD,NEW YORK 11971 v • T
,. Alteration
Telephone 0,�� �t.
Qc;, $10.00 - Residential
%(631) 765-1800 -�l $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE ck\\4617
APPLICANT NAME: CAf/5/c f j,1- 5.4c9,4„,�h1
APPLICANT ADDRESS: /0/5 // Qr4-Lj,rd Gaye.
50v-iho/7l
SEPTIC X CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
�G w Ramsden I,a 5rsic4.,
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Chi./ s'i/OtvAhire
OWNER MAILING ADDRESS: 445 Peev4sA 4v{
c -4.9_,Pc, A/7 x,93 5
OWNER PROPERTY ADDRESS: /O/S/ OrcharA GQy.e
Sovgi
TELEPHONE NUMBER OF CONTACT PERSON:`,
TAX MAP NO. : Section q() Block 'T Lot 15
CROSS STREET:
BUILDING PERMIT NUMBER CROSS. REFERENCE:
Sig . ,ifApplicant
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RECEIVED BY: ,P
Town Clerk's Office
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DATE: ()\\O v