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Home My WebLink AboutPark, William •,, ;gUf FOL Off, 49 .k, JUDITH T.TERRY �•�� Town Hall, 53095 Main Road TOWN CLERK C "� P.O. Box 1179 t Southold, New York 11971 REGISTRAR OF VITAL STATISTICS O �� Fax(516) 765-1823 MARRIAGE OFFICER �� y � RECORDS MANAGEMENT OFFICER .. ?i #0.1 Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER • �,��1� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1705 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : WILLIAM AND TERRI PARK Address 1 : P. O. BOX 1089 City St Zip CUTCHOGUE NY 11935 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 #R10-97-0088 Name Of Owner PARK, WILLIAM AND TERRI Mailing Address 1 P. O. BOX 1089 City St Zip CUTCHOGUE NY 11935 Property Address 1 4225 BRIDGE LANE City St Zip CUTCHOGUE NY 11935 Tax Map No. section 84.00 block 4 lot 11 .003 Cross Street RT. 25 AND RT. 48 Building Permit Number Cross Reference: Issue Date: 7/30/97 Judith T. Terry Southold Town Clerk (TOWN SEAL) I,,oe of FOL j c G' �S ff o . Gym JUDITH T.TERRY � _ Town Hall, 53095 Main Road TOWN CLERK yL P.O. Box 1179 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS O � MARRIAGE OFFICER � y �I Fax (516) 765-1823 RECORDS MANAGEMENT OFFICER =�0,( � 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: July 29, 1997 Transmitted herewith is a copy of application No. Septic Tank Construction Permit submitted by: 17Th for aCesspool/ William and Terri Park 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. �r��C-mow Linda J. Cooper * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: ignatu Dated / -3o/c) 3 o/c) Ij11LLU 'OFFICE OF THE TOWN CLERK $ c�.��VF001- D -lows of Southold Judith T. Terry, town Clerk % Application No. / 7 7 Town Ball, 53095 Main Road ` • t J Construction X -- P. O. Box 1179 Southold, New York 11971 O Alteration Telephone _al t It`e Residential (516) 765-1801 '"""1� Non-Residential TOWN OF SOUTIIOLD SOUTIIOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ ------------- DAT E__________‘144111 APPLICANT NAME: APPLICANT ADDRESS: -_C t.. ____cam -A3.57._________________-__-_ . .__- SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION --- ---_...UR_] _. LOCATION MAP: Must be attached hereto before permit may be issued. • LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION : OWNER OF PROPERTY : ---- Q.en_a TEr_ S___EIC _�— — _ OWNER MAILING ADDRESS: 90__ ____.\..015,q QA-kna-Z& OWNER PROPERTY ADDRESS: .. TELEPHONE NUMBER OF CONTACT PERSON : / a?_17 _ TAX MAP NO. : Section 4N I3locic ' CROSS STREET : _R-Ick cDS q_. BUILDING PERMIT NUMBER CROSS RE =ERENCE : A . I _ _ _ ig lure Applicant RECEIVED BY : – -- R+ Ic's ice DATE : 1UC 2- 1997- _ - Southold Town Clerk . u ANY ALTERATION OR ADDITION TO THIS SUIVEY/S A VIOLATION lam familiar with the STANDARDS FOR APPROVAL OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS AND CONSTRUCTION OF SUBSURFACE SEWAGE 1 hEREON ARE VALD FOR THIS MAP AND COPES THEREOF OAL Y F • ‘ • 0 ....,t_11 DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES 1 WHOSE.SAID MAP OR CAPES BEAR TIE IMPRESSED SEAL OF THE SURVEYOR j and will abide by /he conditions set forth therein and on the WA TLRE APPEARS Hpermit to construct. N ADDITIONALLY To COMPLY 117771 SAD LAW THE TERM ALTERED BY' s; 4- MUST BE USED BY ANY AAD ALL SLRVEYORS UTILJZING A COPY mon' / SN- w a i I OF ANOTHER SURVEYOR'S MAP. TERMS SUCH AS INSPECTED'AAD Deli ^ . Qom. O 'aROU9IT-To-OATE`ARE NOT N COPUL4NCE WITH THE LAW. 61. i 3 a+ o The locations of wells and cesspools <<�q `. / shown hereon are from field observations ec ' { and or from .data obtained from others. Lot C) e ,% ‘15 WV a : - oP J�� i' d'� Z 311# • COUNTY Der AliM�ROPSIAt.�i KEt 0 5maw9 fv T'� 1 IL \ . . . _ . .. • '.1. --: -V 1 p ka 1 \ ©� EMUS URN MAO CONI OATS 0!APPROVAL ti '' \ ' 'y.0. Qom'. 5 % • .. ..� °P \ 3\5' �5 56 y� - k o SURVEY OF h �G� P o Ft0 LOT 3 4 -9� , . ,- , FROM MINOR SUBDIVISION MAP k. OF �'� ��o -R P " SHAL VEY PROPERTIES // `r ° FILED JULY 16, 1990 FILE NO. 8975 �3? , o' �' AT CUTCHOGUE 4 se 59 ` 5 TOWN OF SOUTHOLD �r>v ; 5• aG SUFFOLK COUNTY, N. Y. co �`�Z. METjF� 1000 - 84 - 04 - 11.3 >� 4-# * O CERTIFIED TO' SCALE: 1"= 50' �! WILLIAM W. PARK MARCH 27, 1995 ,•, , --- 'S N I.C. NO. 49618 COMM L. PARK COMMONWEALTH LAND TITLE INSURANCE April l6, /997 (SCDHS INFO) COMPANY ! PECONI $_" ,a t VYO � BRiDGEHAMPTON NATIONAL BANK (516) 765 1+r,4 P. 0. BOX 'lA[i© MAIN ROAD CONTOUR LINES ARE REFERENCED TO SOUTHOLD, KY. /1971 AREA = 20382 ACRES THE FIVE EASTERN TOWNS TOPOGRAPHIC MAPS . ii d 11 95 - 141 - ..