HomeMy WebLinkAboutColwell, Robert o._..
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JUDITH T.TERRY � _ 1 Town Hall, 53095 Main Road
TOWN CLERK y Z P.O. Box 1179
v. Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER t. y*0j �av°0�' Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER =
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` JUDITH T.TERRY411_ 'y�`� Town Hall, 53095 Main Road
TOWN CLERK yz P.O. Box 1179
%REGISTRAR OF VITAL STATISTICS O �� Southold, New York 11971
MARRIAGE OFFICER �-** O.-1 Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER .( -4 .0 Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ,rs.'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO : Southold Town Building Department
FROM: Linda J. Ccoper, Southold Town Clerk's Office
DATED: October 31, 1996
Transmitted herewith is a copy of application No. 1633 for a Cesspool/
Septic Tank Construction Permit submitted by:
East Isle Custom Builders, Inc, for Robert Colwell •
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments: ,� , (57C' `l/2'4C.'3J
Signature Air7
Dated
OFFICE OF THE TOWN CLERK •,i" "--,
Town of Southold CO OLked
Judith T. Terry, Town Clerk � crG Application No.) &3)
Town Hall, 53095 Main Road Z Construction
P. O. Box 1179
.7'
Southold, New York 11971 1� Alteration
Telephone ‘y�,f' � � $10.00 - Residential
f.
(516) 765-1801 ' ..f/ �� �
,, $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE _ °,/ c�
APPLICANT NAME: - - ���V vvvv , ,
APPLICANT ADDRESS: if"'"' .iisioPP7-siw,AP" _ !/
/
SEPTIC >( CESSPOOL K.
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONST UCT ION OR ALTERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: ;3 �I AO if
_ / ' /U
,/
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 72-7 - Cp d L3
TAX MAP NO. : Section Block ! Lot
CROSS STREET: .,.
BUILDING PERMIT NUMBER CROSS REFERENCE: s---1---e?
Signature of Applicant
RECEIVED BY:
Town erk's Office
DATE: /q,)//9 _---
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OL . ` Jao ROBERT P. COL WEL L. Jr.
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W ( r ' LAUREL COUNTRY ESTATES '
c 441
o O ��\i_ o FILED JUNE 22, 1970 as No. 5466 1
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�,,,,ss,,, TOWN of sOUTNOLO, MAX\ 'oJ°•, WELL :n"'iM".�*....�:,� LUFFOL K COUNTY, • �L 2 1996
O LOT 21 o :i ' .. i�csr.....aeawrt MIA
`I RESIDENCE %�0., • .,,=,,�.,.wassam NEW YORK
WELL . RESIDENCE eeeeree�rs}**••evewr.w.+'•�
LP LP Pt�'rKa ' w ;j, BEA. OF
SURVEYED APRIL 27. I99� H StN18.1
-
-91.5)2 [� TECHNICAD LAND SURVEYING
THE EXISTENCE OF WETLANDS. RIGHTS OF WAY. AND/OR SUFFOL OUN TAX MAP NUMBER
O Q p � PAUL W. WERL ER. L.S. NYS L IC 049875
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EASEMENTS. IF ANY NOT SHOWN. ARE NOT GUARANTEED. � I000-K 25-04-08
126 UN/ON AVENUE
—( COPYRIGHT 1996 by
j / CENTER MOR IEHES. NEW YORK 1/934
0 ILzn.I ZONING R-+o T ECHN I CAD L AND%, DATUM - sua(ED
-'i ± & SURVEYING iS i - 15161, 878-2847
`� - -- LOT AREA - 23418.2 .1- S.F. OR 0.5376 ACRES JOB • 96142
I FAX 15161 874-4164