HomeMy WebLinkAboutInland Homes Inc (6) ,,��,o��SpFfO(k�oG.
JUDITH T.TERRY 11_P y< Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
T Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax(516) 765-1823
MARRIAGE OFFICER , -*# a ���
RECORDS MANAGEMENT OFFICER : .1 d Fax
(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. 1440 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : INLAND HOMES INC.
Address 1 : P. O. BOX 117
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-95-0067
Name Of Owner INLAND HOMES INC.
Mailing Address 1 P. O. BOX 117
City St Zip MATTITUCK NY 11952
Property Address 1 315 WESTPHALIA ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 103.00 block 4 lot 20.000
Cross Street LITTLE NECK ROAD
Building Permit Number Cross Reference:
Issue Date: 2/22/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY `� = - , Town Hall, 53095 Main Road
TOWN CLERK I y Z , P.O.Box 1179
REGISTRAR OF VITAL STATISTICS O I� Southold,New York 11971
MARRIAGE OFFICER `Wt• 0* 0 Fax(516)765-1823
RECORDS MANAGEMENT OFFICER : 491 * ,..1.6 Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER o—...,, 0"
OFFICE OF THE TOWN CLERK -
TOWN OF SOUTHOLD
5 I
TO: Southold Town Building Department GC?f
,i.,
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 14, 1996
Transmitted herewith is a copy of application No. 1497 for a Cesspool/
Septic Tank Construction Permit submitted by:
Inland 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 application and location map of the project cited above
and make the following recommendations:
APPROVE (-. ---------
DISAPPROVE
�DISAPPROVE
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OFFICE OF THE TOWN CLERK c;,trO(k -
Town of Southold GNO
VOA H Town- Clerk r'"• f Application No. l7r/
9,
Judith T. Terry,
Hall, ~ '
Town 53095 Main Road c l'�,�� '
P. O. Box 1179 U' t, ,94. i�fi Construction
Southold, New York 11971 �4` -�` r qtr Alteration
Telephone 1 r' •f Residential
(516) 765-1301 n�
Non-Residential
TOWN .OF SOUTHOLD
•
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
APPLICATION
•
•
for
CONSTRUCTION or ALTERATION PERMIT .
•
SEPTIC TANK or CESSPOOL
•
Permit No. •
Fee '$
•
. • DATE 2/14/96
APPLICANT NAME: In' sinrl Homes IIIC• . •
APPLICANT ADDRESS: PO Box 117,mattituck,11952
•
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
New Single Family Dwelling
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Inland Homes Inc.
• OWNER MAILING ADDRESS:
•
OWNER PROPERTY ADDRESS: 315 West. phailia. Rd. ,Mattituck
•
TELEPHONE NUMBER OF CONTACT. PERSON: 298_ 696
TAX MAP NO. : Section 103Block .4 •
_Lot 20
CROSS STREET: '
BUILDING PERMIT NUMBER CROSS REFERENCE:_.
•
•
Signature of pplica •
RECEIVED BY: 1/L/A-bi�-�-- '
Town Clerk's Office •
DATE: '� /I 1
SUFFOLK CO. HEALTH DEPT. APPROVAL
- . H. S. NO.
M,, 1, +'11 _. P rO P ERIN
' .v____.. ._._..._. a SINGLE FAMILY DWELLNG.ONLY
- .` t I I- ` - .., 1t,,.,, ,v�' EXPIRES THREE YEARS FROM DATE OF APPROVAL
.- �, . t‘ ;t I t 4'.. .._' I ....._
_s_
Ar STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
<+1' I ,.7..r soi t +o1_D NY. CONFORM TO THE STANDARDS OF THE
SUFFOLK CO. DEPT. OF HEALTH SERVICES.
1E'- 2v1Ei • (S)
APPLICANT
APR 1196
SUFFOLK COUNTY DEPT. OF HEALTH
/ j
SER VICES -- FOR APPROVAL FOR
I err CONSTRUCTION ONLY
J
SC.CM.OF DATE: MY :4 0 1995
, , /
. ierigiii • " WU H. S. REF. NO.: R 0-9 -0a
APPROVED:
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SUFFOLK CO. TAX MAP D SIGNATION:
DIST. SECT. BL CK PCL.
1000 103 4 ^+,,1
OWNERS ADDRESS:
r ;
3i5 WE PH�t.IA ��i�-
.
NEAT T i TUC14. t1/4,1rY• 11952
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�' ., ALF, -40'1 In DEED: L. ►•fr1l-, P.
Al2E:A' 22,6915.F TEST HOLE I STAMP
1! '' : M ONUt�j E I i
Unauthorized aiteraton or addition
to t is survey is a violation of
Section 72011 of to New York State
'Education taw
Copies of this survey map not bearing
the land surveyors Irked seal or
"i,E_i, embossed deal shat not W considered
+
C/.1)1/4$)
to be awtd true mint
Guarantees Indicated hereon shall run
A� only to to pardon 'torn the survey
G C` •\�►� �a�S n t (" �1' LL a prepared.and on Ns Whet to the
ttrri� T gay{ '$ \,,*, , il RPM old
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transferable
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ELEDYNE IPOST NI11329