HomeMy WebLinkAboutDunne, Daniel 0,/II r,
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JUDITH T. TERRY �I_' ?‘N Town Hall, 53095 Main Road
TOWN CLERK ; co) P.O. Box 1179
v- e! Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER 0�O. Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER '1/40.( `1►a��1� Fax
(516) 765-1800
FREEDOM OF INFORMATION OFFICER � ,•s.
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1783 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : DANIEL J. DUNNE
Address 1 : 2175 PINE NECK ROAD
City St Zip SOUTHOLD NY 11971
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 #R10-97-0155
Name Of Owner DUNNE, DANIEL -CONTRACT VENDEE
Mailing Address 1 2175 PINE NECK ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 GRANGE ROAD EXT.
City St Zip SOUTHOLD NY 11971
Tax Map No. section 75.00 block 4 lot 10.000
Cross Street GRANGE ROAD
Building Permit Number Cross Reference:
Issue Date: 12/22/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY � Town Hall, 53095 Main Road
TOWN CLERK N = P.O. Box 1179
rft � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS fr ��
Fax (516) 765-1823
MARRIAGE OFFICER � f0 a�%. Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER _ 1 lxi[ �`
FREEDOM OF INFORMATION OFFICER ' „„ ,•i"°
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 15, 1997
Transmitted herewith is a copy of application No. 1857 for a Cesspool/
Septic Tank Construction Permit submitted by:
Daniel J. Dunne .
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 recom endations:
APPROVE
DISAPPROVE
Comments:
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Southold, New York 11971 '� . Residential
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CON STRUCTION or ALTERATION PERMIT
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. SEPTIC TANK ". CESSPOOL
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Permit No.
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APPLICANT NAME:' ' -�����?�-L��J-_-~�_
APPLICANT ADDRESS: 2 Co(
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SEPTIC �^ CESSPOOL •
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|)[S( | [I()N ()F PROPOSED CONSTRUCTION OR ALTERATIONJL '---------'-------
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LOCATION MAP: Must be attached hereto before permit way be Issued.
• LOCATION OF PROPOSED CONST RUCTION OR /\LTBRATION:
OWNER OF PROPERTY : {� �g ' /
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OWNER MAILING ADDRESS:
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TAX MAI' NO. : Section �"� (Uvd, �� Lot_ '
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BUILDING PERMIT NUMBER qR|.SS |�EFEREN[E '. '^
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