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Inland Homes inc (3)
e o�O// s�f FO�, 00 •• JUDITH T.TERRY � °� 'yam Town Hall, 53095 Main Road TOWN CLERK y P.O. Box 1179 V". Southold, New York 11971 REGISTRAR OF VITAL STATISTICS O MARRIAGE OFFICER `�45f, 0- Fax (516) 765-1823 RECORDS MANAGEMENT OFFICER $alg10' Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER o ,, i�.01, OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1626 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : INLAND HOMES Address 1 : P. O. BOX 117 City St Zip MATTITUCK NY 11952 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. SCHD REF. #R10-96-0102 Name Of Owner INLAND HOMES Mailing Address 1 P. O. BOX 117 City St Zip MATTITUCK NY 11952 Property Address 1 CHABLIS PATH City St Zip SOUTHOLD NY 11971 Tax Map No. section 51 .00 block 3 lot 3.011 Cross Street BURGANDY COURT Building Permit Number Cross Reference: Issue Date: 3/20/97 Judith T. Terry Southold Town Clerk (TOWN SEAL) ,,,tSoS�FFO4-c /6' 2 Off' G JUDITH T.TERRY ��_ y< Town Hall, 53095 Main Road TOWN CLERK ; y P.O. Box 1179 I � Southold, New York 11971 REGISTRAR OF VITAL STATISTICS `Dy MARRIAGE OFFICER � ,��� Fax(516) 765-1823 RECORDS MANAGEMENT OFFICER .� , **O'�� Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER • 01.° , _ OFFICE OF THE TOWN CLERK 1997 TOWN OF SOUTHOLD BLDG. DEPT TflWN OF SC:. r; TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: March 17, 1997 Transmitted herewith is a copy of application No. 1698 for a Cesspool/ Septic Tank Construction Permit submitted by: Inland Homes • 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 MAR 2 '') 1997 Si nature Dated Southold Town Clerk / p/'' ) 7 OFFICE OF THE TOWN CLERK Town of Southold Judith. T. Terry, Town Clerk Application No. Town Hall, 53095 Main Road Construction P. 0.-Box 1179 .._ Southold, New York 11971 Alteration Telephone Residential i (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 2/24/97 4 APPLICANT NAME: Inland Homes APPLICANT ADDRESS: PO Box 117,Mattituck,NY,l'1952 SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION New Single fav+ily iwp11ing LOCATION MAP: Must be attached hereto before permit may be Issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: Inland homes OWNER MAILING ADDRESS: Same as above OWNER PROPERTY ADDRESS: Chah1 is Path,southold (havaelontky woods at Southold TELEPHONE NUMBER OF CONTACT PERSON: 298-9696 TAX MAP NO. : Section 51 Block 03 Lot 3.11 CROSS STREET: Burgandy court BUILDING PERMIT NUMBER CROSS REFERENCE: Signature of Applicant RECEIVED BY: ► own C erk s •ffice DATE: // 7/1 familiar with the FOR -/� ac,,P//'4 tta CONSTRUCTION OF SUBSURFACE SEWP,gROVAL so' 9 DISPOSAL SYSTEMS FOR SINGLE PAUL Y RESIDENCES `� GE ��� and will abide by the conditions set forth therein and on the OA) permit to construct. SUFFOLK COUNTY DEPARTMENT 07 G d FOR APPROVAL OF CONSTRUCT III D a3' �D y DATE_ HS. REF. NO. V a 00•c C j 'J last49, APPROVED IIV WATER aOPP' '�WAGE D>Sp�OgAL h� ____________ (flt , ;o� CdNFORM WTI'R NNa'WLY ANDBTANDANtDB DATAD NO8Y:V y• ,� 21+42' / L' �' Y SURVEY OF o ,� A c� T 11 L 0 3 A CH�4l�!L�O�?JA Y WOODS AT SOUTHOLD �' Q t Ftp SEPT. 241989 ME NO. 8822 tr AT NORTH SOUTHOLD ,, /I ' we// SUFFOLK COUNTY, NY. © g 1000 - 51- 05- au Scale: 1"= 40' OT June 20,1998 4; "-dP p� SPI/ •i v SUFFOLK COUNTY DEPARTMENT t ENT of HEALTH SERVICES 17) 40 a �` I .,.. k MOT FOA APPROVAL OE CONSTRUCTION FOR A h�,ON SINGLE FAMILY MID , ;« ON�jLLY 0,s N , �� # DAlE,\����\ct Sc mum NO. Al v ` /�/ i ��'llU 401111/6 A1�PRONI3D ��. __ .�,V ..� �,, a NOR MIUCTblUM OI' BBIDR�OOMS N 75. b • 2 9 3i w ,�� �RES'iBRBB YEARS FROM LATE of APPROVAL s y �pF NEW Y L � � 0 OT e � 4Q` ME