HomeMy WebLinkAboutBurns, Phillip s,��OSUF F014-
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ELIZABETH A.NEVILLE '�`1 4. �� Town Hall, 53095 Main Road
TOWN CLERK p 1 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v� Southold, New York 11971
O �� Fax (516) 765-1823
MARRIAGE OFFICER : ?i •
RECORDS MANAGEMENT OFFICER "1/4 491 $.i �I� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ,��
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1854 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PHILLIP & JOYCE MARIE BURNS
Address 1 : 139 STRATHMORE GATE DRIVE
City St Zip STONY BROOK NY 11790
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 #R10-98-0060
Name Of Owner BURNS, PHILLIP & JOYCE MARIE
Mailing Address 1 139 STRATHMORE GATE DRIVE
City St Zip STONY BROOK NY 11790
Property Address 1 OLD NORTH ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 55.00 block 1 lot 8.001
Cross Street HORTONS LANE
Building Permit Number Cross Reference:
Issue Date: 4/30/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
•
'���JIM"I /V �(
��,f Og�FFO(�c
ELIZABETH A.NEVILLE
,•0' OGZ�% Town Hall, 53095 Main Road
TOWN CLERK t c %
.� P.O. Box 1179
t y = Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ' �'�1 Fax (516) 765-1823
MARRIAGE OFFICER : *f• �40' , Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER I 0die.
ij) ETHITE .,,
OFFICE OF THE TOWN CLERK j
11 998
TOWN OF SOUTHOLD 2 ( j
;t j, BLDG.DEPT.
•WN •FS•UTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 29, 1998
Transmitted herewith is a copy of application No. 1929 for a Cesspool/
Septic Tank Construction Permit submitted by:
Joseph McCarthy for Phillip and Joyce Burns .
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.
Thank you.
P-d- /"F"-
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
A
ignat r=
Dated
OFFICE OF THE TOWN CLERKci\\FOL�'
Town of Southold
Pg. Application� CDJudith T. Terry, Town ClerkNo. (9r9
Town Hall, 53095 Main Road a =4= Construction Z
P. O. Box 1179 �•� Alteration
Southold, New York 11971 O
01 �� Residential
Telephone
(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 949 QM9d
APPLICANT NAME: P1//LZ/P .J�. .�c�YC�/'j4,'1E 41/,6VS
APPLICANT ADDRESS: /37 ,S'�,(', W,MogI 6441 49/Q/yf
SrOAPI 481f6ok, N•7- //7 90
SEPTIC CESSPOOL ✓
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
///Et✓ ffot',r[
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: A//ILIO J. 5 Soya( vie
OWNER MAILING ADDRESS: /37 d'TRArt gkr
So vy BReat_ 1/79 a
OWNER PROPERTY ADDRESS: 04.0 ,t/otr,y R
Cd(AVM LOjAO, 1/9 71
TELEPHONE NUMBER OF CONTACT PERSON: JOE ,11S >otRyf.y-- 77s-s8/s
TAX MAP NO. : Section „CS-
Block , Lot if°. /
CROSS STREET: lio,Pn c in,✓1
BUILDING PERMIT NUMBER CROSS REFERENCE:.
ignature of Applicant
RECEIVED BY/!
/Too�wn eer Office
DATE: 2.y/ 7 �S
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