HomeMy WebLinkAboutGreenbriar Homes Inc s\OgUfFO[ ,
-ELIZABETH A.NEVILLE t$h`Z`� Gym; Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
y 2 Southold, New York 11971
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REGISTRAR OF VITAL STATISTICS us'
O $7? Fax (516) 765-1823
MARRIAGE OFFICER *4. # �� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER ��Q! J�
FREEDOM OF INFORMATION OFFICER ��1
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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. 1893 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : GREENBRIAR HOMES INC.
Address 1 : 59 HAWXHURST ROAD
City St Zip COLD SPRING HARBOR NY 11724
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 #R10-98-0076
Name Of Owner GREENBRIAR HOMES INC.
Mailing Address 1 59 HAWXHURST ROAD
City St Zip COLD SPRING HARBOR NY 11724
Property Address 1 ALDRICH LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 120.00 block 3 lot 8.008
Cross Street HARVEST LANE
Building Permit Number Cross Reference:
Issue Date: 7/10/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
0 /moi i
ELIZABETH A.NEVILLE t `Z 4 � Town Hall, 53095 Main Road
TOWN CLERK ti Southold,
, P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O Fax (516) 765-1823
Pry
MARRIAGE OFFICER . y ����� Telephone (516) -1823 765-1800
RECORDS MANAGEMENT OFFICER �Ql �� 1
FREEDOM OF INFORMATION OFFICER ��•I* •01,•"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 24, 1998
Transmitted herewith is a copy of application No. 1967 for a Cesspool/
Septic Tank Construction Permit submitted by:
Greenbriar Homes Inc.
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 applic tion and location map of the project cited above
and make the following r commendations:
APPROVE
DISAPPROVE
Comments:
S' atur
ct
Dated
OFFICE OF THE TOWN CLERK ,,c51FOUrr;-)
Judith TT. Terry, Townown of lClerk r��" Application No. /97
Town Hall, 53095 Main Road gConstruction
P. O. Box 1179
to r71 r71
*.k. Alteration
Southold, New York 11971 `0�
Telephone �! Art y►�; Residential
(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 O/20,1
,1
APPLICANT NAME: Gi'oee‘->✓/fJi€/,4-,e ,6&-,i /A/C,
APPLICANT ADDRESS: /71/44e1)0-f///e T ,4)
/cEPOOL
gg4,e ,V> //7 4'
SEPTIC
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/NS124e.-c 17 O N �i� Si -,c G�S S,D fl L
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ��,Gee/4ie genies' /,►/c,
OWNER MAILING ADDRESS: 39 /, fir//ST , b
9 -s4P->i✓l- ,4 4,eB% 44:y
OWNER PROPERTY ADDRESS: 4, ��,-,eey
A/o ,� % ` �� /97,4-7-777-7/e/.
TELEPHONE NUMBER OF CONTACT PERSON: '51;,2/-/4/31
TAX MAP NO. : Section /?O Block 3 Lot cfcr
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:_.
Signature of Applicap/
RECEIVED BY: (L-
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1,/ -„„i„ G-, ,9_6E'�
own Clerk's Office
DATE: l� 6 a. T L9S
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1,...'e,-i LI 1,e-c. i.
VA i. VAL-
IoI.1i "/ 11- 4.0 -9X)&- IL . 00 Ioo.S THE WATER'SUPPLY&SEWAGE
DISPOSAL FOR THIS RESIDENCE
V fiebPoSest WILL CONFROM TO THE STAND-
wcu. ARDS OF THE SUFFOLK COUNTY
'4' I 6e ,. DEPT.OF HEALTH SERVICES.
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Unauthorized alteration or addition to this document is a violation of Section 7209 SURVEY OF: I
of the New York State Education Law. Q
Certifications indicated hereon shall run only to the person for whom it is prepared T r
and on his behalf to the Title Company,Governmental Agency and Lending MAP O.F • 1't /IG1 A Atm.4, rtbInstitution listed hereon,and to the assignees of the lending institutions or subse- Iv``�{iV n 1��
quem owners. �/►/► T F
Copies of this document not bearing the professional's inked seal or embossed /�1A ,1 1� 1 t Q{�N Q
seal shallfnot ts be consideredimion ) valtrue copy. � 1 1
The peseta(or os dimensions)shown hereon froare structures the hrty linesctiare 1 V ' \./
for a specific purpose and use and therefore are not intended to gyide the erection of �\
fences,retaining walls,pools,patios,planting areas,addition to buildings or any other
construction f NE ,•
The existence of right of ways and/or easements of record,if any,not shown are O RiI /' i
not guaranteed. ��t . DATE: 1 q g :SCALE: I = S0
DEST)I G.GRA _
CERTIFIED ONLY TO: t1 -8' DESTIN GNI 4•
cl,..,.., , r LAND SURVEYO ..R
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By f �. �\ 73 WOODLAWN ROAD
DESTIN G.GRAF N.Y.S.LIC No.50067 ROCKY POINT,NEW YORK 11778 O
TAX I.D.No. ± PHONE(516)821-3442
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