HomeMy WebLinkAboutDelane, Patricia ,gVF 0 of
JUDITH T.TERRY �is yt Town Hall, 53095 Main Road
TOWN CLERK y i P.O. Box 1179
v' ^P I Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
1
MARRIAGE OFFICER0=434, \'•
' Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER Ul * `�►a•d6 Telephone(516) 765-1800
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. 1724 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : PATRICIA & DONN PAUL DELANE
Address 1 : 34 JAKES LANE
City St Zip CALVERTON NY 11933
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 #R10-97-0126
Name Of Owner DELANE, PATRICIA AND DONN-PAUL
Mailing Address 1 34 JAKES LANE
City St Zip CALVERTON NY 11933
Property Address 1 WHITE EAGLE DRIVE
City St Zip LAUREL NY 11948
Tax Map No. section 127.00 block 9 lot 23.000
Cross Street LAUREL WOODS ROAD
Building Permit Number Cross Reference:
Issue Date: 8/28/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFOLt
O`' [ 'êco
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JUDITH T.TERRY %4 A 'y�•
Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS � �1� Fax(516) 765-1823
MARRIAGE OFFICER : �� .0.001. Telephone Tele hone (516) 765-1800
RECORDS MANAGEMENT OFFICER .j `�► 0=1 P
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: August 27, 1997
Transmitted herewith is a copy of application No. 1795 for a Cesspool/
Septic Tank Construction Permit submitted by:
Patricia and Donn Paul DeLane
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:
RECEIVED
AUG 2 81997 11-) -�—
Signa e
Southold Town Clerk Z /4 Th
Dated
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(U'F|��E 0F l�}|E l�0VVN CLE|�K
`w" o/ ShuUhnN
Judith l� -Ferry, [ow/� ClerkApplication No. /~� c���
l\,w" Hall, 64095 Main Road Construction
P. 0.U. Oox 1179 -' - -
Southold, New York 11971 Alteration
.
Telephone • • Residential
(516) 76S- |80l '��// �'°
� Non Residential. .
TOWN OF 60UT||0LD
SOU1101U WASTEWATER DISPOSAL DIST RICT
AP|`L|CAT ION
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CONSTRUCT ION or NTBRAT|UN PERMIT
SEP 1. TANK ,v CESSPOOL
Permit No.
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Fee $
DATE
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APPLICANT NAkAE: g-_--'----- __ ^~. -~n--._.�'-'_- -___-_---_
A| `|]CANT A|}DRESS: 311-
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SEPTIC CESSPOOL
|)ES(]R|PTION OF PROPOSED CONSTRUCT ION OR ALJERATION
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LOCATION MAP: Must he attached hereto before permit may be Issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERAT ION :
OWNER OF PROPERTY : al et bon n- pa &Lone
OWNER MAILING ADDRESS:
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OWNER PROPERTY ADDRESS ' / � � � � �/h �e E-03/e_
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TELEPHONE NUMBER OF CONTACT PERSON : 3673
lAX MAP NO. : Section / I mock 9 Lot 'a3
-_`7
CROSS STREET ' � ^��� ������
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13U|LU|NC PERMIT NUMBER CROSS REFERENCE : 4
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[<[CE|VEU
erk's Office
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DATE : X -1-7.9 ------- '--_ __
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JOB NO.9 7 -`3 19 FILE NO. -
` Il!! OMITS (OR DIMENSIONS) GUARANTEES INDICATED.KIWI* • GOLDEN .VI W STK,
SHOWN HEREON, FROM THE ITIALL RUN ONLY IQ THE MOON
STRUCTURES TO'THE PROPERTY POR WHOMURVTI
. THE 13 TRE. SURVEYED FOR
i 11Ne1 ME POR A SPECIFIC PUB- PARED, AND ON HIS INHALE 1O
POS! ANS USE AND:'THEREFORE THE TITLE COMPANY,_ GOVER MI�>- LOT N U M B E R 23
•
ARE 110E INTI JEST -TO GUIDE THE TAL AGENCY AND LENDING INTI- • #'
tRK71ON OF FENCES, RETAINING TUTION LISTED HEREON,,AND• TO MAR OF GOLDEN VIEW S1 ,Q e, ,.
"'+VALLS,. POOLS, MTI06, .FLAMING• ,i:.THE ASSIGNEES OF:THE LENDING R
.All'!AS, ADDITION TO SUILDINGS INSTITUTION. GUARANTIES ARE
7RAM0N6TRU
OIH6t0GJpN. NOT''TRANSFfRASLE 7O ADDITIONAL F
,r- INSTITUTIONS OR SUISEQUENT
SITUATED AT L A(),R E L tl
JNAUTHORIZED .ALTERATION OROWNERS.
MERTTON TO.NI SURVEY' eS A TOWN OF SO U-T H O L D . SUFFOLK COON T Y-.N<1 y
.lIlTLA1TON of SECTION TM OF COPIES OF THIS VW MAP NOT
HE MN YORK STATE 'EDUCATION SEARING THE,*LAW SURVEYOR'S
NOT'RE SCALE
AW NNNCEo 3/AL at mimeo SEAL ir
' 1" _ 4•Q' DATE 7 * 2-4`r 1 Q 117
SHALL =tamer To $1 s
fa • ' A.YA .,wlv,r,r' FILE NO. 7 7 7 0 DATE ' S R;:. • 1934 1
*•GUARANTEED .ONLY TO or NE
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4,4t. IM1�;}•O •
�., - waxMAP N . 1000-12,7 , 9 -23 (REF ON )015 4'�.
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f, TRAN0 �'�. , S,i'ff"' HAROLD F, TRANCHON JR i C. #.
1.
I.` i ¢Ov' �� u�u Q i 991 LAND SURVEYOR g -,
r x� -,� Q1.: * A • � LSA r4 tiJCCESSOR TO WILLIAM G. MVER '
` j 'n �:.. I�'`" { Ias11 ADING RIVER-MANOR RD. WADING RIVER;
I ' 'L -�" NEW YORK, 11792 ' ,
I,IJAR LD F TRANCHON y�'4'0 A l ►• �r4. NO 048992
tit5-E 516-929-4695