HomeMy WebLinkAboutSeire, Philip ti
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JUDITH T.TERRY • Town Hall, 53095 Main Road
TOWN CLERK ; yf ‘ ,
- P.O. Box 1179
• • Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER y 9- Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER = 49.� `�►aO 1�� 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. 1784 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : WALTER PESTER
Address 1 : 3440 WELLS ROAD
City St Zip PECONIC NY 11958
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 #R10-97-0163
Name Of Owner SEIRE, PHILIP V.
Mailing Address 1 46 MARINER CIRCLE
City St Zip WEST ISLIP NY 11795
Property Address 1 SKUNK LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 97.00 block 4 lot 7.003
Cross Street EUGENE ROAD
Building Permit Number Cross Reference:
Issue Date: 12/22/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY �0 _ yj Town Hall, 53095 Main Road
TOWN CLERKt y Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O
��� Southold, New York 11971
MARRIAGE OFFICER 1'. 0� /�, Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER "4..-:491� *00d. Tele shone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ,0,, O O If
,
DEC,
OFFICE OF THE TOWN CL D : . 1 8I'T ' €
TOWN OF SOUTHOLD
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TOWN OF -, r I
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 18, 1997
Transmitted herewith is a copy of application No. 1858 for a Cesspool/
Septic Tank Construction Permit submitted by:
Walter Pester for Philip V. Seire .
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 r7p'mmendations:
APPROVE
DISAPPROVE
Comments:
.7Signatur
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Dated
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Town Hall, 51095 Main Road i 1.:(:',..,
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P. O. flux 1179 s Ltir-). 1' 1t7..,'.•••, '•,t • •
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Southold, New York 11971 , Nv.
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Telephone : 44,4 ,, • • Residential ---------
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Non' Residential. . . . _ .. _
•rowri OE SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DI ST R ICT
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APPLICAT ION
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CON ST R UCT ION Or A I.T I.R AT ION !TIM IT
• SEPT IC TANI< iii CESSPOOL
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Permit No,............ ...... . .
Fee $
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DATE
APPLICANT ...\, :54...... _
APPLICANT ADDRESS:...,.
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e_coo.se_ .iQxI .11 i Cels
SEPTIC CESSPOOL
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DESCRIPT ION OF PROPOSED CONSTRUCT ION OR ALTERAT ION.._......_...__.... ..... ....... .
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. . ....... _ . .._........_________...._...... _ .
LOCAl.ION MAP: Must be attached hereto before permit way be Issued.
LOCATION OF PROPOSED CONST 111.1C I. ION OR ALTERA 1. ION :
OWNER OF PROPER•TY ....._....?t,u..kt .....V.....:5.c...\h_fg.,...
OWNER MAILING AD1)11ESS: 1.--i‘ C. . _ . ..._......
. ...-_0,3e..--s7-. _ -T5..1..Q. 1J .t."3 \11cact. .. U.25 S----
OWNER PROPERTY ADDRESS : "5 ).vsX. .. .. ... ........ . .
TELEriioNE !Atm/HIER OF CONTAC•I PERSON : -2 ( – '75.4 1
I AX MAI' NO. : Section 9 i 1,1„0, Lt • .3
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(;Ross. S TR EE.I .. " f "• . , ..
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HUMMING PERMIT NUMI3E11 CROSS RELERENCE. : 't
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RECEIVED 11Y : ALCM-----"--12---
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DATE : / a:// -/P>
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N/O/F
N1VlNGHAM i am familiar with the STANDARD OR APPROVAL The locations of wells and cesspools '`
pATR " CU AND CONSTRUCTION OF SUBSUR CE SEWAGE shown hereon are from Field observation
DISPOSAL SYSTEMS FOR SINGLE MIL Y RESIDENCES and or from
data ob/aub/ed /ram o/hers.
and will abide by the conditions set 1•.h therein and on the
IdIs,,,„i; . permit lo construct. D ,
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CONTOUR t11ES ARE REFERENCED TO .
MPS VE EASTERN TOWNS TOPOGRAP IC,
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«:: LOT s �.` i 56.1.51 4 �O MADE FFOR VILED 11%1,0 r,r, �. A ti 2.
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MGIST$E; ISED aAM1^AIIG ALL' YQgS A COPY F •�,`� �// • ^� ..5. LJ NO. 4 -. •
OF ANOTHER EGRYEyp'W 1,A1! Ma 6IAC I 'INSPECTED'AtC i..�Y!��YiC..4
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VROUGHT:TO.OAIE`ARE NOT N GOIPL1Al11 WITH TIE LAM. AREA - g8 65 ft. ' ,30' .G Sutton County
f5/6J ti
or 265. 12 0 BOX 9619
sr T OCT 2 91997
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