HomeMy WebLinkAboutGreenbriar Homes Inc (4) .0 A,- coG.
JUDITH T.TERRY
.
...it 44 Town Hall, 53095 Main Road
TOWN CLERK o P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS V°
� Fax(516) 765-1823
MARRIAGE OFFICER ‘#/#AGEMENT OFFICER aQ�/'�� Telephone (516) 765-1800
FREEDOM ORECORDS F NFORMATION OFFICER 1 ,�°
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1687 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.
Name Of Owner GREENBRAIR HOMES INC.
Mailing Address 1 59 HAWXHURST ROAD
City St Zip COLD SPRING HARBOR NY 11724
Property Address 1 FARMVEU ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 121 .00 block 7 lot 3.000
Cross Street HARVEST LANE
Building Permit Number Cross Reference:
Issue Date: 6/17/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•;
.0 \Q SCD .
JUDITH T.TERRY I p%* 4 Town Hall, 53095 Main Road
TOWN CLERK ;N P.O. Box 1179
v. n� �� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O Fax(516) 765-1823
MARRIAGE OFFICER `. y N �/
RECORDS MANAGEMENT OFFICER = ,( * ,a/��a��� Telephone (516) 765-1800
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: June 12, 1997
Transmitted herewith is a copy of application No. 1757 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. 3 ;: 7
Linda J. Cooper
* * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE '/
Comments: ►'1.,e:f.,t�ai QF C wQ 1 "rexrp f 6 d ct_
RECEIVED
JUN 1 .,; 1997 ignat
-s1
Dated
Southold Town Clerk
jILLLL
'Of=r ICE OF THE TOWN CLERK OCA iOti'`,'
Down of Southold .. O�-+ •• Application No.
Judith I-. Teri Town Clerk ` PI 57
Town Ilall, 53095 Main Road Construction ,---%
'
P. O. Box 1179
Southold, New York 11971 Off, Alteration 7 -
Telephone °l * It � Residential v
(51 6) 765-1801 � 'rmfaif
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee
DATE 00_2
APPLICANT NAME: Ci ,1r1,g,/,4/2- ,01 E'er' /A,G
APPLICANT ADDRESS: /t//4#0c-,V61/257- ,416-_ --- -- --- —
CTG goP/ N 6- ///�iei" O/Q,,_ AO( f/ v.2
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before Kermit may be issued.
• LOCAT ION OF PROPOSED CONSTRUCTION OR ALTERATION :
OWNER OF PROPERTY : G 6,/,e.e°,, g! /17-7>72.67.S /A/C,
OWNER MAILING ADDRESS: ,5-9 biegGoXgd,€S.% /0-p
OWNER PROPERTY ADDRESS:_--/59,40-m4-4/./,A9_,11-6 -- —
TELEPHONE NUMBER OF CONTACT PERSON : (1._<7J fL -/-/f.0
TAX MAP NO. : Section 4al Block 7 Lot 3
CROSS STREET : //Av' "s �. El ✓ ..
BUILDING PERMIT NUMBER CROSS REFERENCE :
_.,-e)-7z...ez___ ,1., . .a, '--t" ‘2,0...
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Signature of Applicant
Ae,�i1146;e4 04e,Me.s ,,
RECEIVED BY : C,.6
Town TowOffice
DATE: ——
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• I SUFFOLK CO. HEALTH DEPT. APPROVAL
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TuFFOLK COUNT?DMPARMENT°P REAM'SERV/
path=poR APPROVAL OF CONSTRUCIVN '*
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APPROVED
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POR MAXIMUM QF...„,Z_BEDROOMS
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SUFFOLK CO. TAX MAP DESIGNATION:
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DIST. SECT. BLOCK L.
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OWNERS ADDRESS:
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Cold inq Harbor., N.Y. 11724
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RODERICK VAN TUYL. P.C. '14i " r ,,/... :
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"Mot, o-4 FarrriVeUr fi led in -the
Suffolk Co.Dept of Peel Services -`' •za--.e.a43'
Suffolk Courtrai Clerk's office
EtlWatinentai Protiction LICENSED LAND SURVEYORS A- AfAr • '
a 5 GREENPORT NEWYOR
Map NO. 8808.
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